The placenta cretas involve ingrowths of placental tissue into the uterine wall, causing the placenta to be abnormally adherent and difficult to remove.
Complications of placenta creta:
(1) severe maternal hemorrhage
(2) placenta rupture
(3) emergency hysterectomy
(4) endometritis (if remnants of the placenta are left behind)
(5) fetal morbidity and mortality
Common gross findings:
(1) difficult or impossible placenta extraction
(2) highly fragmented basal plate with torn cotyledons
Histologic findings:
(1) absence of the decidual layer
(2) trophoblasts extending directly into the myometrium or into uterine blood vessels
(3) abnormal maternal vascular remodeling
Term |
Finding |
placenta accreta, partial |
extension of trophoblasts into the superficial myometrium over a limited area of the basal plate |
placenta accreta, totalis |
extension of trophoblasts into the superficial myometrium over the entire basal plate |
placenta increta |
trophoblasts invade deeply into the myometrium but not through |
placenta percreta |
trophoblasts invade through the placenta, penetrating the serosa |
Placenta increta and percreta need to be separated from malignant trophoblastic tumors.
Specialty: Obstetrics & Gynecology