| Placenta Percreta
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Etiology
• Unknown
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Pathogenesis
• Absent decidua at implantation site due to scar or abnormal implantation site (cervix)
• Permits deep invasion of trophoblast either into very superficial myometrium preventing easy separation at delivery (accreta), deeply into myometrium (increta) or through myometrium into adjacent organs (percreta),
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Epidemiology
• Associated with placenta previa
• Associated with previous C-sections
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General Gross Description
• In simple accreta the maternal surface of the placenta is shaggy and irregular with variable amounts of fragmentation of the cotyledons
• In increta or percreta the placenta cannot be removed from the uterus at all and rupture of the uterus is a common complication
•Examples:
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General Microscopic Description
• Accreta may show adherent myometrium along the basal plate of the placenta
• Increta/percreta show villi growing into or through myometrium
•Examples:
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Clinical Correlation
• Associated with uterine rupture, hemorrhage, and failure to deliver placenta
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References
• Blaustein's Pathology of the Female Genital Tract, 4th ed. Kurman RJ (ed). New York: Springer-Verlag, 1994, pp. 984-5.
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| Placenta Percreta
| | Synopsis by: Melinda Sanders M.D. (T82000M14430)[312]
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