A diagnosis of placenta accreta is suspected. Why is this a concern and what is the common management plan?

A diagnosis of placenta accreta is suspected. Why is this a concern and what is the common management plan?

• A. It can cause placenta to fail to detach, resulting in postpartum hemorrhage; often requires cesarean delivery with possible hysterectomy
• B. It accelerates placental separation
• C. It has no effect on delivery
• D. It is managed with vaginal delivery with oxytocin

Answer: (D)

Placenta accreta occurs when the placenta attaches too deeply into the uterine wall, so it cannot detach normally after the baby is born. This makes postpartum hemorrhage a major concern because the placental tissue may bleed profusely as the uterus tries to contract and separate it. Because controlling this bleeding is crucial, the common management plan is to deliver by cesarean section with the team prepared for a possible hysterectomy to remove the uterus if necessary to stop the hemorrhage. Relying on vaginal delivery with oxytocin isn’t appropriate here, since the abnormal placental adherence means the placenta may not detach and bleeding can be uncontrollable. The care plan also involves having blood products ready and a multidisciplinary team to manage potential massive blood loss.

Placenta accreta occurs when the placenta attaches too deeply into the uterine wall, so it cannot detach normally after the baby is born. This makes postpartum hemorrhage a major concern because the placental tissue may bleed profusely as the uterus tries to contract and separate it. Because controlling this bleeding is crucial, the common management plan is to deliver by cesarean section with the team prepared for a possible hysterectomy to remove the uterus if necessary to stop the hemorrhage. Relying on vaginal delivery with oxytocin isn’t appropriate here, since the abnormal placental adherence means the placenta may not detach and bleeding can be uncontrollable. The care plan also involves having blood products ready and a multidisciplinary team to manage potential massive blood loss.