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Placenta Accreta

Disease Details

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Description: Placenta accreta is a condition where the placenta grows too deeply into the uterine wall and remains attached after childbirth, potentially causing severe bleeding.
Type: Placenta accreta is not typically considered a genetic disorder and does not follow traditional patterns of genetic transmission. It is a condition where the placenta attaches too deeply into the uterine wall, which can cause complications during delivery. Although certain risk factors, such as previous cesarean sections and other uterine surgeries, may increase the likelihood of placenta accreta, it is not inherited in a genetic sense.
Signs And Symptoms: Placenta accreta is a serious pregnancy condition where the placenta grows too deeply into the uterine wall.

**Signs and Symptoms:**
1. **Vaginal Bleeding:** During the third trimester, bleeding without pain can be a sign. It's often the most noticeable symptom.
2. **Premature Labor:** Can occur due to the abnormal attachment.
3. **Iron Deficiency Anemia:** Caused by chronic bleeding.
4. **Fatigue:** Due to anemia and blood loss.
5. Often there are no symptoms until delivery.

**Risk Factors:**
- Previous uterine surgery (e.g., C-sections)
- Placenta previa
- Maternal age over 35
- Multiple pregnancies

Due to the risk of severe bleeding during delivery, close monitoring and a planned C-section are often recommended.
Prognosis: Placenta accreta is a serious pregnancy condition where the placenta abnormally attaches too deeply into the uterine wall. This can cause severe bleeding during delivery.

**Prognosis:**
The prognosis can vary based on the severity and management. With proper prenatal care and planned delivery often involving a multidisciplinary medical team, the risks can be managed more effectively.

**Nan:**
"Nan" is likely shorthand for a more specific term. In the medical context of placenta accreta, it might not directly apply. Can you provide more context or clarify the term "nan"?
Onset: Placenta accreta is a condition that occurs when the placenta attaches too deeply into the uterine wall. The onset is generally during pregnancy and is usually diagnosed in the third trimester through ultrasound or MRI. Symptoms may not be evident until after delivery, but it can be suspected in women with risk factors such as a history of placenta previa, previous cesarean sections, or other uterine surgeries. Early detection and management are critical to prevent significant complications.
Prevalence: The prevalence of placenta accreta varies by population and risk factors but is generally estimated to occur in about 1 in 533 to 1 in 2,500 pregnancies. The rise in cesarean delivery rates has contributed to an increased incidence over recent years.
Epidemiology: The reported incidence of placenta accreta has increased from approximately 0.8 per 1000 deliveries in the 1980s to 3 per 1000 deliveries in the past decade.
Incidence has been increasing with increased rates of caesarean deliveries, with rates of 1 in 4,027 pregnancies in the 1970s, 1 in 2,510 in the 1980s, and 1 in 533 for 1982–2002. In 2002, ACOG estimated that incidence has increased 10-fold over the past 50 years. The risk of placenta accreta in future deliveries after caesarian section is 0.4-0.8%. For patients with placenta previa, risk increases with number of previous caesarean sections, with rates of 3%, 11%, 40%, 61%, and 67% for the first, second, third, fourth, and fifth or greater number of caesarean sections.
Intractability: Placenta accreta can be challenging to manage due to its complications, but it is not universally intractable. Management often requires a multidisciplinary approach, including specialized obstetric care, surgical planning, and sometimes interventions such as hysterectomy. Early detection and careful planning can significantly improve outcomes, although severe cases may still present substantial risks.
Disease Severity: Placenta accreta is a serious pregnancy condition that occurs when the placenta attaches too deeply into the uterine wall. This condition can lead to severe complications, including massive blood loss during or after delivery. It varies in severity but typically requires advanced medical care, which may include surgical intervention such as a hysterectomy.
Healthcare Professionals: Disease Ontology ID - DOID:4744
Pathophysiology: Pathophysiology: In placenta accreta, the chorionic villi, an essential part of the placenta, invade too deeply into the uterine wall and fail to separate after childbirth. This abnormal adherence can involve varying depths of invasion:
- Placenta accreta: villi attach to the myometrium without penetrating it.
- Placenta increta: villi invade into the myometrium.
- Placenta percreta: villi penetrate through the myometrium and can extend to nearby organs, such as the bladder.

This condition is often linked to defects in the decidua basalis, possibly due to previous uterine surgeries, such as cesarean sections, which result in scar tissue that disrupts normal placental attachment. The invasive nature of the condition can lead to complications like severe hemorrhage during delivery, as the placenta does not detach properly from the uterine wall.
Carrier Status: Placenta accreta is not a condition associated with carrier status as it is not a genetic disorder. Instead, it is a pregnancy complication where the placenta attaches too deeply into the uterine wall. This condition can lead to severe bleeding during delivery. Early detection and proper medical management are crucial for the health and safety of both the mother and the baby.
Mechanism: Placenta accreta is a condition where the placenta attaches too deeply into the wall of the uterus. This can lead to severe complications during childbirth.

**Mechanism:**
Placenta accreta occurs when the decidua basalis (the uterine lining) is deficient or absent, allowing the placental villi to invade into the myometrium (the muscular layer of the uterine wall) instead of being confined to the decidual layer. This abnormal attachment can be divided into three types based on the depth of invasion:
1. Placenta accreta: superficial attachment to the myometrium.
2. Placenta increta: deeper invasion into the myometrium.
3. Placenta percreta: penetration through the myometrium and serosa, sometimes affecting other organs.

**Molecular mechanisms:**
The molecular mechanisms underlying placenta accreta involve several factors:
1. **Improper Decidualization:** Inadequate formation of the decidua basalis impairs the normal barrier and allows for deeper placental invasion.
2. **Angiogenesis and Vascular Remodeling:** Alterations in the expression of angiogenic factors such as vascular endothelial growth factor (VEGF) and placental growth factor (PlGF) can contribute to abnormal vascular remodeling and deeper invasion.
3. **Extracellular Matrix (ECM) Dynamics:** Altered expression of proteins involved in ECM remodeling, such as matrix metalloproteinases (MMPs) and their inhibitors (TIMPs), facilitates the invasion of trophoblast cells into the myometrium.
4. **Cell Adhesion Molecules:** Abnormal expression of cell adhesion molecules like integrins and cadherins may influence the attachment and invasive behavior of trophoblast cells.

These molecular changes collectively contribute to the abnormal implantation and invasive behavior of the placenta in placenta accreta.
Treatment: Treatment may be delivery by caesarean section and abdominal hysterectomy if placenta accreta is diagnosed before birth. Oxytocin and antibiotics are used for post-surgical management. When there is partially separated placenta with focal accreta, best option is removal of placenta. If it is important to save the woman's uterus (for future pregnancies) then resection around the placenta may be successful. Conservative treatment can also be uterus sparing but may not be as successful and has a higher risk of complications.
Techniques include:

Leaving the placenta in the uterus and curettage of uterus. Methotrexate has been used in this case.
Intrauterine balloon catheterisation to compress blood vessels
Embolisation of pelvic vessels
Internal iliac artery ligation
Bilateral uterine artery ligationIn cases where there is invasion of placental tissue and blood vessels into the bladder, it is treated in similar manner to abdominal pregnancy and manual placental removal is avoided. However, this may eventually need hysterectomy and/or partial cystectomy.If the patient decides to proceed with a vaginal delivery, blood products for transfusion and an anesthesiologist are kept ready at delivery.
Compassionate Use Treatment: Placenta accreta is a condition in which the placenta grows too deeply into the uterine wall. This can lead to severe complications during childbirth. There are no specific compassionate use or off-label treatments commonly recognized for managing placenta accreta, as treatment primarily focuses on surgical intervention.

1. **Surgical Management**: The primary treatment is often a planned cesarean section followed by a hysterectomy (removal of the uterus) to prevent life-threatening hemorrhage.

2. **Conservative Surgery**: In some cases, conservative surgical methods may be attempted to preserve the uterus, but this can be risky and is not universally recommended.

Research on experimental treatments or alternative management strategies is ongoing, focusing mainly on surgical innovations and improving outcomes with less invasive techniques, but these are generally within clinical trial settings and not widely available as standard treatment options.
Lifestyle Recommendations: Placenta accreta is a serious pregnancy condition where the placenta grows too deeply into the uterine wall. While specific lifestyle modifications can't prevent or treat placenta accreta directly, general recommendations for a healthy pregnancy can be beneficial. These include:

1. **Regular Prenatal Care**: Attend all scheduled appointments to monitor the health of both mother and baby.
2. **Follow Medical Advice**: Adhere to your healthcare provider’s recommendations, especially if you have a history of placenta previa or previous cesarean sections, which are risk factors.
3. **Healthy Diet**: Ensure a balanced diet rich in vitamins and minerals to support overall pregnancy health.
4. **Quit Smoking**: Smoking cessation can improve overall pregnancy outcomes.
5. **Avoid Alcohol and Drugs**: Steer clear of alcohol and recreational drugs to reduce risks to the fetus.
6. **Manage Stress**: Engage in stress-reducing activities like light exercise, yoga, or meditation.
7. **Discuss Delivery Plans**: Work closely with your healthcare team to develop a safe delivery plan, given the increased risk of complications with placenta accreta.

These steps support overall maternal health, which is essential when dealing with any high-risk pregnancy condition.
Medication: Placenta accreta is a condition where the placenta abnormally attaches itself too deeply into the uterine wall. Currently, there are no specific medications to treat placenta accreta. Management typically involves careful monitoring during pregnancy and planning for delivery, which often includes a cesarean section followed by a hysterectomy to prevent severe bleeding.
Repurposable Drugs: There are currently no well-established repurposable drugs specifically for placenta accreta. Standard management primarily involves careful surgical planning, often requiring cesarean hysterectomy to prevent severe hemorrhage and other complications. Research is ongoing to identify potential pharmaceutical interventions.
Metabolites: Placenta accreta is a condition where the placenta attaches too deeply into the uterine wall. It is not directly characterized by specific metabolites that are universally recognized for its diagnosis or study. However, research may identify some biochemical markers associated with abnormal placentation, but these are not yet standardized for clinical use. If you need more information, particularly concerning any metabolites that may be implicated in the latest research, it would generally be detailed in recent medical studies or specialized literature.
Nutraceuticals: Nutraceuticals currently have not been established as a treatment or preventive measure for placenta accreta. This condition typically requires specialized medical management through interventions such as surgery or advanced obstetric care. It is crucial to consult with a healthcare provider for appropriate diagnosis and treatment options.
Peptides: “Placenta accreta” is a condition where the placenta attaches too deeply into the uterine wall, potentially leading to severe complications during delivery. While peptides are not a standard treatment approach for placenta accreta, research into peptide-based therapies is ongoing in various medical fields. For placenta accreta, the primary treatments typically involve surgical intervention, such as a planned C-section and possible hysterectomy to manage bleeding and other complications.