| Placenta Accreta
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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 muscle (accreta), deep muscle (increta) or through the serosa (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
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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
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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 Accreta
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| Synopsis by: Melinda Sanders M.D. (T88100M29210)[418]
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