The spectrum of placental accreta: a narrative review
DOI:
https://doi.org/10.36557/2674-8169.2025v7n2p91-104Keywords:
Placenta Accreta, Postpartum Hemorrhage, Maternal Mortality, Cesarean SectionAbstract
This article aimed to analyze the epidemiological, pathophysiological, and interventional characteristics of placenta accreta, an obstetric condition associated with severe complications during childbirth. Articles published between 2019 and 2024, in English and Portuguese, were selected through the PubMed database, using terms related to placenta accreta. Placental accreta is characterized by abnormal invasion of the placenta into deep layers of the uterus, including the myometrium and, in severe cases, adjacent organs. Among the most established risk factors are previous cesarean sections and uterine manipulations, such as curettage and surgical hysteroscopy. Although often asymptomatic during prenatal care, this condition is one of the main causes of postpartum hemorrhage, associated with adverse obstetric outcomes, such as maternal death. There is no specific treatment for placenta accreta, but clinical management aims to prevent severe bleeding, with hysterectomy being necessary in most cases. Early identification of placenta accreta during prenatal monitoring is essential for adequate birth planning, allowing for the optimization of obstetric care and improvement of maternal prognosis.
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References
ARAKAZA, A. et al. Placenta Accreta Spectrum Diagnosis Challenges and Controversies in Current Obstetrics: A Review. International Journal of Women’s Health, v. 15, p. 635–654, 2023.
ARAÚJO, I. F. M. et al. Complicações e manejo do acretismo placentário: uma revisão integrativa. Brazilian Journal of Implantology and Health Sciences, v. 6, n. 6, p. 2210–2225, 2024.
BARTELS, H. C. et al. Placenta Accreta Spectrum: A Review of Pathology, Molecular Biology, and Biomarkers. Disease Markers, v. 2018, p. 1–11, 2018.
BOOKER, W.; MOROZ, L. Abnormal placentation. Seminars in Perinatology, v. 43, n. 1, p. 51–59, 2019.
CAMARGO, J. S. O.; ALMEIDA, M. C. A enfermagem diante o acretismo placentário. Revista Científica Eletrônica de Ciências Aplicadas da FAIT, v. 1, p. 1–11, 2021.
CONCATTO, N. H. et al. Achados na ressonância magnética do espectro do acretismo placentário: ensaio iconográfico. Radiologia Brasileira, v. 55, n. 3, p. 181–187, 2022.
COUTINHO, C. M. et al. Espectro do acretismo placentário: recomendações atualizadas da perspectiva do profissional de imagem pré-natal. Femina, v. 51, n. 6, p. 326–32, 2023.
DAR, P.; DOULAVERIS, G. First-trimester screening for placenta accreta spectrum. American Journal of Obstetrics & Gynecology, v. 6, n. 5, p. 1–12, 2024.
EROL, F. M. et al. Placenta Accreta Spectrum (PAS): Diagnosis, Clinical Presentation, Therapeutic Approaches, and Clinical Outcomes. Medicina, v. 60, p. 1–16, 2024.
GHOSH, A. G. et al. Placenta Accreta Spectrum: An Overview. Seminars in Interventional Radiology, v. 40, p. 467–471, 2023.
GUIMARÃES, A. P. P. et al. Relato de caso: placenta percreta com invasão vesical. Revista Eletrônica Acervo Saúde, v. 24, n. 4, p. 1–7, 2024.
HECHT, J. L. et al. Classification and reporting guidelines for the pathology diagnosis of placenta accreta spectrum (PAS) disorders: recommendations from an expert panel. Modern Pathology, v. 33, p. 2382–2396, 2020.
JAUNIAUX, E. et al. Placenta accreta spectrum: pathophysiology and evidence-based anatomy for prenatal ultrasound imaging. American Journal of Obstetrics & Gynecology, v. 218, p. 75–87, 2017.
JENABI, E. et al. Maternal Smoking and the Risk of Placenta Accreta Spectrum: A Systematic Review and Meta-Analysis. BioMed Research International, v. 2022, p. 1–6, 2022.
LIU, X. et al. What we know about placenta accreta spectrum (PAS). European Journal of Obstetrics & Gynecology and Reproductive Biology, v. 259, p. 81–89, 2021.
LOUREIRO, R. C. et al. Cesariana de gestante com placenta prévia e acretismo seguido de histerectomia devido sangramento maciço. Revista Eletrônica Acervo Saúde, v. 13, n. 1, p. e5787, 2021.
ROZEIRA, C. H. B. et al. Acretismo placentário: relação das complicações no parto. Brazilian Journal of Implantology and Health Sciences, v. 6, n. 3, p. 1095–1111, 2024.
SABBAGH, S. et al. Acretismo placentário e suas complicações. Femina, v. 50, n. 4, p. 254–256, 2022.
SILVA, A. K. L. et al. Acretismo placentário e suas complicações: revisão integrativa. Brazilian Journal of Implantology and Health Sciences, v. 6, n. 3, p. 1574–1586, 2024.
SILVA, A. R. S. et al. Hemorragia pós-parto. Revista Eletrônica Acervo Saúde, v. 24, n. 12, p. 1–8, 2024.
SUGAI, S. et al. Pathologically diagnosed placenta accreta spectrum without placenta previa: a systematic review and meta-analysis. American Journal of Obstetrics & Gynecology, v. 5, n. 8, p. 1–9, 2023.
TANNURE, T. F. et al. Acretismo placentário de diagnóstico tardio: relato de caso. Revista de Ciências Médicas e Biológicas, v. 18, n. 1, p. 135–137, 2019.
VERDUGO-LIZÁRRAGA, E. et al. The Underlying Molecular Mechanisms of the Placenta Accreta Spectrum: A Narrative Review. International Journal of Molecular Sciences, v. 25, p. 1–13, 2024.
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Copyright (c) 2025 Thiago José Islanderson dos Santos Castro, Felipe Viana Ferreira Gomes, Luiza Magalhães Emerenciano, Carolina Magalhães Emerenciano, Ana Paula Angeline Uzêda Lodi, Amanda Vanessa de Melo Sampaio, Felipe De Novaes Alves, Jéssica Raianne Silva Cruz, Daniel da Silva Borges, Anna Luísa Braga Fagundes, Palloma Oliveira de França, Claudianne Borges da Silva Bispo, Helena Eduarda Terres Hennrichs
This work is licensed under a Creative Commons Attribution 4.0 International License.
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