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Adhesion

Adhesion

Adhesion occurs when one type of molecule is attracted to a different molecule. Water exhibits adhesive properties in the presence of polar surfaces, such as glass or cellulose in plants. For instance, when water is poured into a glass, the positively charged hydrogen molecules of water are more attracted to the negatively charged oxygen molecules in the silica than to the oxygen in neighboring water molecules.
Capillary action is a result of water’s adhesive tendencies. When a narrow glass...

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Accurate and Simple Evaluation of Vascular Anastomoses in Monochorionic Placenta using Colored Dye

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Placenta Praevia with Abnormal Adhesion-A Retrospective Study.

Lucian Șerbănescu^1,2, Dragoș Brezeanu^1,2, Cătălin Nicolae Grasa^1,2

¹Faculty of Medicine, Ovidius University of Constanta, 900470 Constanta, Romania.

Clinics and Practice

|February 25, 2025

Summary

Early diagnosis of placenta accreta spectrum (PAS) is vital. Advanced imaging like ultrasound and MRI accurately detect PAS, enabling multidisciplinary management for better maternal and fetal outcomes.

Keywords:

caesarean section hysterectomy placenta accreta placenta praevia

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Area of Science:

Obstetrics and Gynecology
Maternal-Fetal Medicine
Diagnostic Imaging

Background:

Placenta accreta spectrum (PAS) encompasses abnormal placental adherence (accreta, increta, percreta), with rising incidence linked to increased cesarean sections.
PAS poses significant risks, including severe hemorrhage, hysterectomy, and potential fetal complications like preterm birth and anemia.
Timely diagnosis of PAS is critical for effective management and improved patient outcomes.

Purpose of the Study:

To evaluate the diagnostic accuracy of imaging modalities for placenta accreta spectrum (PAS).
To identify risk factors associated with PAS.
To underscore the importance of multidisciplinary care in managing PAS.

Main Methods:

Retrospective analysis of 13,841 deliveries from 2018-2022.
Diagnosis of placenta previa and PAS using ultrasound and MRI, confirmed by histopathology.
Data collection from clinical records and operative protocols.

Main Results:

Identified 25 cases of placenta previa (0.82%) and 17 cases of PAS (0.57%).
Ultrasound showed 88% sensitivity, MRI 94% sensitivity for PAS detection.
Previous cesarean sections (94.1%), smoking, and fibroids were key risk factors; all 3 percreta cases involved bladder invasion.

Conclusions:

Smoking, uterine scars, and fibroids are significant risk factors for pathological placental adhesion.
Ultrasound and MRI offer high accuracy for PAS diagnosis, with histopathology as the gold standard.
Multidisciplinary management and timely surgical intervention (cesarean section with hysterectomy) are crucial for optimal outcomes, especially in complex cases with organ invasion.