Early Detection of Adhesive Placenta Previa in Cesarean Section

Abstract

Placenta previa is a placenta that has implanted in the lower uterine segment, thus covering all or part of the internal uterine ostium. The prevalence of placenta previa in developed countries ranges from 0.26 to 2.00% of all pregnancies, while in Indonesia it has been reported by several researchers to range from 2.4 to 3.56% of all pregnancies. Sectio cesarean is a risk factor for placenta previa and the risk of causing placenta accreta which can increase cases of bleeding and hysterectomy. However, placenta accreta can only be established after delivery. So that early detection of placenta accreta can be used to determine the condition of the placenta during pregnancy. In cesarean section, an incision is made in the uterine wall so that it can result in atrophic changes in the decidua and reduced vascularity resulting in the placenta moving to a place with higher vascularity or sticking deeper at the implantation site. The Placenta Acreta Index is a value for each sonographic parameter that is used to assess the probability of the extent to which the placenta invades the uterine wall. The probability value of placental invasion is included with the total score. Where the total value is 0.1,2 and so on up to above 8 in a row with an invasion probability value of 5%, 10%, 19%, 33%, 51%, 69%, 83%, 91% and 96%. Placenta accreta in former cesarean section can be confirmed by the placenta accreta index score.