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:

1. Placenta accreta- the placental chorionic villi adheres to the superficial layer of the uterine myometrium.
2. Placenta increta– the placental chorionic villi invade deeply into the uterine myometrium.
3. 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

1. Associated findings. Placenta accrete is usually diagnosed in the immediate post partum period when the placenta fails to separate.
2. Clinical manifestations
   • Placenta fails to separate
   • Profuse hemorrhage may result depending on the portion of placenta involved.

Nursing Management

1. Identify placenta accreta in the client. Be aware of the client’s risk status.
2. Assist with rapid treatment and intervention. Be prepared for a D&C or hysterectomy.
3. Provide physical and emotional support.
4. Provide client and family education.