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This chapter discusses the implications, diagnostic signs, and management strategies of the condition called morbidly adherent placenta. The definitive diagnosis can be made only at surgery. Ultrasound examination with colour Doppler and MRI scans may aid diagnosis. Antenatal diagnosis should be made to ensure optimum outcome. For women with placenta percreta, management options include conservative management of the placenta (intentional retention of placenta or IRP) elective caesarean hysterectomy with or without bladder resection or uretetric implantation or the 'Triple P Procedure'. Radical surgical management involves total abdominal hysterectomy with or without bladder resection for placenta percreta. Patients should be managed in obstetric high dependency unit or ITU to recognise and manage complications. Patient compliance should be ensured prior to embarking on conservative management as delay in treatment for secondary haemorrhage or sepsis may increase maternal morbidity and mortality.
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