Placenta accreta

Introduction Placenta implantation refers to the invasive part of the myometrium of the placenta. The placenta is like a long tree root. It is intricately dispersed and deeply rooted in the uterine muscle wall. The implanted part of the placenta cannot be peeled off by itself. Damage to the myometrium. Pathology Under the microscope, villi can be seen invading into the myometrium. Placental implantation is a rare and critical complication of obstetrics, which can lead to major bleeding, shock, uterine perforation, secondary infection, and even death. In the past, the uterus was often removed in order to save the patient's life. Placenta implantation is a complication of obstetrical morbidity. It is not easy to diagnose whether it is pregnant or at birth or after childbirth. Once the disease causes severe postpartum hemorrhage, if it is not timely and decisive treatment, it will endanger the life of the woman. Placental implantation is a rare complication of obstetrics, and the incidence rate has increased in recent years. In order to avoid the consequences of resection of the uterus, it is of great significance to explore the use of conservative treatment for placenta implantation while saving the patient's life. After clinical observation, the combination of traditional Chinese and western medicine for placenta implantation has achieved good results.

Cause

Placental implantation is common in endometrial traumatic or inflammatory injury or scar formation, so it occurs in the history of abortion, history of uterus, cesarean section, history of free placenta stripping, previous placenta implantation or history of placenta previa , endometritis, submucosal uterine fibroids, local mucosal atrophy, maternal, gestational age of 35 years of age, after radiotherapy. Abortion and cesarean section are currently considered to be important causes of placenta implantation.

an examination

Related inspection

Obstetric B-ultrasound magnetic resonance imaging (MRI)

Clinical manifestations:

After the baby is delivered, the placenta does not last, with or without vaginal bleeding.

Auxiliary diagnosis:

1B super (preferred): there is no clear boundary between the placenta and the uterus attachment surface; the contact surface shows the cavity inside the placenta, and abnormal blood flow enters the myometrium.

2 magnetic resonance imaging (MRI): for understanding the degree of placenta implantation, whether it violates the adjacent organs has a certain value.

3 endoscopy: deeper placenta implantation can penetrate the uterus to the outside of the serosa and involve the bladder backwards can involve the sigmoid colon. Laparoscopy, cystoscopy and sigmoid colon examination are feasible for suspicious cases.

Differential diagnosis

(1) Adhesive placenta: The villi are directly attached to the myometrium of the uterus, and there are two types of complete and partially adherent placenta. Such a placenta may be partially peeled off by itself, but some of the uterine cavity may remain, which requires manual peeling. The operation is difficult, but a part of the muscular layer tissue may be involved. It is difficult to determine whether there is a lack of basal aponeurosis from the naked eye or under the microscope. Such as hysterectomy specimens, in the placenta and adhesion of the uterine wall in multiple places, in order to find the decidual defect, the villi directly contact the myometrium.

(2) Implantable placenta: the villi invade part of the myometrium, the implanted part can not be peeled off by itself, and the myometrium is damaged by artificial peeling. Pathology Under the microscope, villi can be seen invading into the myometrium.

(3) penetrating placenta: villi invade the myometrium and penetrate the uterine muscle wall directly to the serosa, often causing uterine rupture.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.