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Management of the morbidly adherent placenta (placenta accreta, increta, and percreta)

Robert Resnik, MD
Robert M Silver, MD
Section Editors
Charles J Lockwood, MD, MHCM
Deborah Levine, MD
Deputy Editor
Vanessa A Barss, MD, FACOG


Management of patients with a morbidly adherent placenta (placenta accreta, increta, or percreta) varies widely in the United States [1,2]. Although the impact of a morbidly adherent placenta on pregnancy outcomes is well-described, no randomized trials and few studies have examined the management of pregnancies complicated by this disorder. As a result, recommendations for its management are based on case series and reports, personal experience, expert opinion, and good clinical judgment.

The management of placenta accreta, increta, and percreta will be discussed here and is essentially the same, except when a percreta extends to extrauterine tissue. Unless otherwise noted, the following discussion of management of placenta accreta applies to all depths of placental invasion. The clinical features and diagnosis of the morbidly adherent placenta are reviewed separately. (See "Clinical features and diagnosis of the morbidly adherent placenta (placenta accreta, increta, and percreta)".)


All patients with suspected placenta accreta should be counseled about the diagnosis and potential sequelae (eg, hemorrhage, blood transfusion, cesarean hysterectomy, maternal intensive care unit admission). Consultation with a maternal-fetal medicine specialist is desirable, and transfer to a center of excellence for placenta accreta is strongly advised.

For patients with placenta previa-accreta, prenatal care follows typical guidelines for management of placenta previa (see "Placenta previa: Management"):

Correction of iron deficiency anemia, if present

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Literature review current through: Nov 2017. | This topic last updated: Feb 03, 2017.
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