title: Morbidly Adherent Placenta: Interprofessional Management Strategies for the Intrapartum Period.
abstract: "Morbidly adherent placenta" is a term that describes the continuum of placenta accreta, increta, and percreta. The incidence of this type of abnormal placentation has increased significantly over recent decades. The reason is probably multifactorial but, partly, because of factors such as the increasing number of cesarean births. Women at greatest risk are those who have myometrial damage caused by a previous cesarean birth, with either anterior or posterior placenta previa overlying the uterine scar. This condition poses significant risks of morbidity and/or mortality to the pregnant woman and her fetus. A multidisciplinary approach to care throughout pregnancy is essential. This article describes the classification of morbidly adherent placenta, risk factors, methods of diagnosis, potential maternal and fetal complications, and intrapartum clinical management strategies to optimize outcomes.
authors: Clinical Concepts in Obstetrics, Inc, Brentwood, Tennessee (Dr McMurtry Baird), Vanderbilt University School of Nursing, Nashville, Tennessee (Dr Kennedy); and Ms Troiano is a perinatal nursing consultant in high risk and critical care obstetrics in Arley, Alabama.
authors: Suzanne McMurtry
authors: SM
authors: Baird
authors: Nan H
authors: NH
authors: Troiano
authors: Margaret Betsy Babb
authors: MB
authors: Kennedy
mesh_terms: D002585:Cesarean Section / Q000009:adverse effects / Q000379:methods / Q000451:nursing; D019468:Disease Management; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D009736:Nursing Process; D010348:Patient Care Team / Q000458:organization & administration*; D010920:Placenta; D010921:Placenta Accreta / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D011247:Pregnancy; D018570:Risk Assessment; D016216:Ultrasonography, Prenatal / Q000379:methods; D014592:Uterine Hemorrhage / Q000209:etiology / Q000451:nursing / Q000601:surgery