Pathological attachment of the placenta: diagnosis, management and delivery

The incidence of placenta previa is 0.2-0.9% but continues to be one the most serious factors in development obstetric’s bleeding and perinatal losses. situation aggravated by fact that combined with various variations abnormal (deep) attachment uterus (placenta adhaerens, accreta, increta, percreta). Placenta previa, vasa cause significant maternal morbidity mortality. With increasing both cesarean delivery pregnancies using assisted reproductive technology, these 3 conditions are becoming more common. Placental accretion remains main hemorrhage obstetric hysterectomy, resulting significantly high Risk for include prior delivery, pregnancy termination, intrauterine surgery, smoking, multifetal gestation, parity, age. Advances ultrasound have facilitated prenatal diagnosis placentation allowing multidisciplinary management plans achieve best outcomes mother baby. Purpose - review literature on placentation, including an evidence-based approach diagnosis, treatment; follow evolution this pathology recent years complications may arise. Identification risk factors, correct antenatal preoperative treatment counseling will help overall women accreta reduce morbidity. According literature, it can concluded true or percreta, as well suspected (for example, cases a history caesarean section anamnesis), should managed delivered tertiary health facility. In no case separated if edematous blood vessels visible placental flow after laparotomy found area anterior wall uterus, when percreta increta. As tactic, not only primary hysterectomy considered, also conservative therapy delayed (two-stage hysterectomy). where partial cannot accurately diagnosed, good understanding hemostasis balloon catheter occlusion, methods suture hemostasis, total procedures considered. No conflict interests was declared author.