What to do if the placenta implants into the uterus
Placenta accreta Spectrum (PAS) is a serious pregnancy complication in which the placenta attaches abnormally to the myometrium or even penetrates the uterine wall. In recent years, as cesarean section rates have increased, so has the incidence of placenta accreta. The following is a detailed analysis and response plan for placenta accreta.
1. Types and risk factors of placenta accreta
| Type | Description |
|---|---|
| Placenta Accreta | Placenta attached to the myometrium but not penetrated |
| Placenta Increta | Placenta invades the myometrium |
| Placenta Percreta | The placenta penetrates the uterine wall and may involve nearby organs |
| risk factors | Description |
|---|---|
| History of cesarean section | Especially if you have a history of multiple cesarean sections |
| placenta previa | placenta covering cervix |
| Elderly pregnant women | Age ≥35 years increases risk |
| History of uterine surgery | such as uterine myomectomy |
2. Diagnostic methods for placenta accreta
Early diagnosis is key to reducing risk, mainly through:
| Check method | Features |
|---|---|
| Ultrasound examination | The preferred method, with an accuracy of about 80%-90% |
| MRI examination | Provide clearer images for complex cases |
| clinical manifestations | Such as painless vaginal bleeding and abnormal uterine contractions |
3. Treatment plan for placenta accreta
Treatment needs to be tailored based on the severity of the condition and the patient’s reproductive needs:
| treatment plan | Applicable situations |
|---|---|
| Conservative treatment | Part of the placenta remains and there is no infection, MTX medicine is used |
| hysterectomy | Severe bleeding or placenta percreta, especially if there is no need for childbearing |
| uterus-sparing surgery | Local lesion resection + uterine reconstruction requires an experienced team |
4. Prevention and precautions
1.Pre-pregnancy assessment:Women with high-risk factors should consult a doctor before becoming pregnant.
2.Standardized prenatal examination:Especially for those with a history of cesarean section, ultrasound monitoring needs to be strengthened.
3.Choose the right hospital:Patients with suspected placenta accreta should be referred to a tertiary hospital for delivery.
4.Postpartum observation:Even if the surgery is successful, you still need to be wary of delayed bleeding.
5. Latest research progress (hot spots in the past 10 days)
1.Interventional therapy applications:Arterial embolization can reduce intraoperative blood loss.
2.Biomarker research:Serum PAPP-A levels may be associated with placenta accreta.
3.International guidance updates:In 2023, FIGO recommends multidisciplinary teams to manage severe cases.
Although placenta accreta is dangerous, most patients can achieve good outcomes through standardized management and timely intervention. Pregnant women should maintain regular prenatal check-ups and seek medical attention promptly if any abnormalities are found.
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