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Citation: Oviedo Venerio JE, Giblin G, Torrez M, Mercado M. Placenta Accreta Spectrum: A preventable nearly iatrogenic
disorder.Jr.med.res.2021;4(1): 24-25. Oviedo et al © All rights are reserved. https://doi.org/10.32512/jmr.3.2.2020/24.25
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Images in clinical practice
Oviedo Venerio Javier Enrique
1,3, **
, Giblin Gary
3
, Torrez Magdaly
1,2
, Mercado Martha
1,3
.
Placenta Accreta Spectrum: A preventable nearly iatrogenic disorder.
1: Department of Obstetrics and gynecology ,Oscar
Danilo Rosales Hospital, León, Nicaragua
2: Department of pathology , Oscar Danilo Rosales
Hospital, León, Nicaragua
3: Universidad Nacional Autónoma de Nicaragua,
León, Nicaragua
** Academic editor
Correspondence to:
Javieroviedo2004@yahoo.com
Publication Data:
Submitted: February 10,2021
Accepted: March 21,2021
Online: May 30,2021
This article was subject to full peer-review.
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Intraoperative features of cesarean hysterectomy for placenta percreta
Color Doppler ultrasound shows multidirectional flow vascularity and artifacts.
Intraoperative finding shows tortuous vessels in the serosal surface of gravid uterus.
Placenta Accreta Spectrum: A preventable nearly iatrogenic disorder
Citation: Oviedo Venerio JE, Giblin G, Torrez M, Mercado M. Placenta Accreta Spectrum: A preventable nearly iatrogenic
disorder.Jr.med.res.2021;4(1): 24-25. Oviedo et al © All rights are reserved.
Submit your manuscript: www.jmedicalresearch.com.
Comments
Placenta accreta spectrum (PAS) refers to the range of pathologic adherence of the placenta, including placenta
increta, placenta percreta, and placenta accreta. PAS disorder is a maternal and fetal life-threatening situation due
to the high risk of intrapartum uncontrollable bleeding. The common described risk factors are the placenta previa
and history of Caesarean section (CS) [1]. We herein report our experience with five patients referred to our
department for suspected PAS. These patient were selected for targeted prepartum ultrasound assessment due
to their history of multiple C-sections. PAS risk increase with the number of previous CS and could reach7% [2].
In Nicaragua , the rate of c-section in obstetrical practice is still high and approximating 40% in some centers.
Uterine wall dehiscence result in locally defective decidualisation and abnormal placental adherence with important
trophoblastic invasion in a subsequent pregnancy [3]. We still believe that this disorder is preventable if we “go
back” a little to obstetrical good practices. Dramatic situations can be avoided by selecting suspected PAS on
ultrasound or MRI to be referred. PAS is the commonest cause of intrapartum hysterectomy and must be managed
always in specialized centers with multidisciplinary team approach.
25
Conflict of Interest: None
References
[1] Bloomfield V, Rogers S, Leyland N. Placenta accreta spectrum. CMAJ. 2020;192:E980.
[2] Morlando M, Collins S. Placenta Accreta Spectrum disorders: Challenges, risks, and management strategies. Int J Womens Health. 2020;12:1033-45.
[3] Badr DA, Al Hassan J, Salem Wehbe G, Ramadan MK. Uterine body placenta accreta spectrum: A detailed literature review. Placenta. 2020;95:44-52
