Professional Documents
Culture Documents
Pathophysiology:
Implantation in an area of defective
endometrium with no zone separation
between the placenta and the myometrium.
Incidence: 1 and 2500 pregnancies
Mortality rate: as high as 10% with
percreta
Signs and Symptoms:
There are no apparent symptoms
Diagnosis:
-Ultrasound
› loss of the normal hypoechogenic zone between the
placenta and myometrium
abnormality of the smooth interface between the
uterus and bladder a Swiss- cheese appearance to
the placenta, with hypoechogenic spaces within
pulsatile flow of the maternal blood into the
hypoechogenic spaces.
-MRI
ASSESSMENT
Associated findings. Placenta accreta is
usually diagnosed in the immediate
postpartum period when the placenta
fails to separate.
Clinical manifestations
a. Placenta fails to separate
b. Profuse hemorrhage may result
depending on the portion of placenta
involved.
Diagnosis
-risk for infection related to excessive
blood loss/ exposed placental
attachment site.
-risk for injury related to attempted
manual removal of retained placenta
Planning
-reduce hemorrhage
-to maintain normal v/s and lab.values
Interventions
Pharmacologic : Non-Pharmacologic :
-methotrexate -witch Hazel
-oxytocin -lady’s mantle
-analgesia -cotton root bark
-Identify placenta accreta in the
client. Be aware of the client’s risk
status.
- Assist with rapid treatment and
intervention. Be prepared for a
dilation and curettage or
hysterectomy.
- Provide physical and emotional
support.
- Provide client and family
education.
Witch - hazel Lady’s mantle