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Morbidly Adherent Placenta

Interprofessional Management Strategies for the Intrapartum Period

Baird, Suzanne McMurtry, DNP, RN; Troiano, Nan H., MSN, RN-C, NE-BC; Kennedy, Margaret (Betsy) Babb, PhD, RN, CNE

The Journal of Perinatal & Neonatal Nursing: October/December 2016 - Volume 30 - Issue 4 - p 319–326
doi: 10.1097/JPN.0000000000000209
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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.

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.

Corresponding Author: Suzanne McMurtry Baird, DNP, RN, Clinical Concepts in Obstetrics, Inc, 1180 Manley Ln, Brentwood, TN 37027 (suzannebaird@att.net).

Disclosure: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

Submitted for publication: July 31, 2016; accepted for publication: August 15, 2016.

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