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PLACENTA ACCRETA

Rex I. Smith, M.D.; C. W. Seibert, M.D.
JAMA. 1942;119(17):1417. doi:10.1001/jama.1942.72830340004008b.
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Placenta accreta is a serious but fortunately a rare complication of labor. Meyer and Ashworth1 found 118 authentic cases after careful search of the literature up to 1940. The reported incidence of this condition differs greatly, varying from 1 in 3,000 to 1 in 40,000 deliveries. As a rough estimate, it probably occurs about once in every 10,000 deliveries.

The chief pathologic change in placenta accreta is a complete or partial absence of the decidua basalis, which allows the villi to burrow directly into the uterine musculature and prevents separation of the placenta after delivery.

Any condition producing primary atrophy of the endometrium may be a predisposing factor. Conditions which have been implicated include previous manual removal of the placenta, too thorough curettage, submucous fibromyomas, endometritis and possibly dyshormonism, since hormones play an important role in the formation of the decidua.

The chief symptom of this condition is brisk

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