Evaluation of Recent Updates Regarding Adherent Placenta, Diagnosis and Management

Kamal Mohammad Khan , Nour Adnan Zahra , Mohammed Adel Alminee , Hassan Mohammad aljadaani , Qaisy Fatima Abutaleb , Sukinah Sadiq Alzahir , Hawra Mohammed Alqatari , Hajar Rida Almoqbel , Seham Saud Al-Anazi , Abdullah Nasser M Alotaibi , Amnah Mohammed Alanazi

Abstract

Background: The adherent placenta is a range of pathologic adherence of the placenta, including placenta increta, placenta percreta, and placenta accreta. Villous invasion depth determines the severity of the complications, and the villi sometimes invade the surrounding pelvic organs. Therefore, any surgical procedure becomes technically difficult, especially with excessive neovascularity. Objective: The prenatal diagnosis of the adherent placenta has become essential to its management and outcome. In this article, we aimed to review the published literature that discussed adherent placenta diagnosis and management. Method: A comprehensive search was done using biomedical databases including Medline, and PubMed to study the role of Adherent Placenta. Keywords used in our search through the databases were “Adherent Placenta”, “Placenta Increta, Placenta Percreta, and Placenta Accreta”, and “Pathophysiology and Management”. Conclusion: The mainstay imaging technique in cases of placenta accreta is ultrasound. Pelvic ultrasound is highly reliable to diagnose or exclude the presence of placental adhesive disorders. However, when the ultrasound results are not conclusive, MRI is recommended, because it has a higher potential benefit. In general, the recommended management of an adherent placenta is planned cesarean hysterectomy with a hysterotomy that avoids the placenta. Appropriate counseling can be conducted to consider alternative management strategies. A center with a multidisciplinary team experienced in the care of the condition should conduct the delivery in order to optimize the response to every peri and intraoperative complication.