Delivery planning in patients with placenta accreta

Obstetric bleeding is the major cause of maternal mortality. One of the causes of massive obstetric bleeding is the placenta accreta. The placenta accreta is the result of an abnormal plantation, it is due to the presence of a defect in the basalis decidua and is characterized by attaching the chorial villi to the uterine myometrium or the uterine serosa. The international obstetric society through the protocols FIGO, ACOF, RCOG, CNGOF comes with a series of recommendations, allows the early detection of pregnancies that could develop the placenta accreta and would allow optimal resolution of these cases. These recommendations concern the planning of the birth of these patients and consist of the counseling of the patient and the establishment of the plan of conduct, the organization of the birth in a tertiary care center perinatal, the consultation and pre-anesthetic counseling, the reservation of blood substitutes, the choice of the termination of pregnancy, the type setting, of skin incision and type of incision on the uterus, protection of the ureters, application of vascular embolization procedures. Proper preoperative training decreases maternal morbidity and mortality caused by increased placenta