Placenta Accreta Nursing Management
Description
- Placenta accreta is an uncommon condition in which the chorionic villa adheres to the myometrium. It can be exhibited as:
- Placenta accreta- the placental chorionic villi adheres to the superficial layer of the uterine myometrium.
- Placenta increta– the placental chorionic villi invade deeply into the uterine myometrium.
- Placenta percreta– the placental chorionic villi grow through the uterine myometrium and often adhere to abdominal structures (eg, bladder or intestine).
Etiology
- Predisposing factors are prior uterine surgery and placenta previa.
Pathophysiology
- Implantation in an area of defective endometrium with no zone separation between the placenta and the myometrium.
Assessment Findings
- Associated findings. Placenta accrete is usually diagnosed in the immediate post partum period when the placenta fails to separate.
- Clinical manifestations
- Placenta fails to separate
- Profuse hemorrhage may result depending on the portion of placenta involved.
Nursing Management
- Identify placenta accreta in the client. Be aware of the client’s risk status.
- Assist with rapid treatment and intervention. Be prepared for a D&C or hysterectomy.
- Provide physical and emotional support.
- Provide client and family education.
