Here is an example I had from a 9th birth. Between births 7 and 8, woman underwent D&C. On eighth birth, had Manual Removal of placenta in hospital, requiring 2 units of blood afterwards. On 9th birth, delivered at home. Placenta did not deliver for 50 minutes. At 50 minutes, placenta was still found to be completely attached and was manually removed with very little bleeding. This is what i looked like. Crumbly and not healthy looking but complete. No further need for intervention. Anyone else have pictures of adherent placentas?
Madam,
This is not a placenta of complete accreta. In complete accreta, placenta if tried to remove, is removed by piecemeal. If I get in the next couple of weeks, I will send you. Did the baby survive? Was it a case of preterm labour?
My experience over 32 years is that there is incredible variation and each case is different.
There were 2 pieces which i put back together for the picture. One 3 cm round piece actually fell out before the revision, which was a unique experience - never happened to me before.
Baby was born fine,with Apgar 10,10 at term.
I believe it was a complete accreta because the whole placenta stayed attached for 50 minutes, and only then did a bit separate, say 2 cm edge giving me enough to start the manual revision process.
Duration of retain is not a factor to determine. I work in a centre where around 20 thousand deliveries are conducted. I got and get many cases. Yes, there are many variations. Pictures given by Mr. Shabib are excellent and rare.
Dear Madam Judy
I had a case somewhat similar to yours about 1 year ago. Manual removal of placenta was done after 40 mins, and the gross abnormalities with crumbly looking as what you show. But I didn’t preserve the picture. I would like to show one postoperative figure regarding the specimen on placenta percreta. The emergent hysterectomy was performed following the cesarean section.
Regards
Dr. GW Bruce Chen
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