REPORT OF A CASE OF RETAINED PLACENTA, CLINICALLY PLACENTA ACCRETA

Recent literature on obstetrics has called attention to the fact that placenta accreta is an extremely rare and verydangerous condition; that while it is a definite pathologic or anatomic entity, it is, in some cases, not possible to make a positive diagnosis if the uterine tissue is not available for microscopic study. The essential characteristic is absolute atrophy of the endometrium, which results in absence of decidua, the chorionic villi penetrating directly into the uterine musculature, in some cases, nearly to the peritoneum. This condition is believed to be caused by an abnormal condition of the inner uterine wall, following vigorous curettage of the uterus, previous manual removal of the placenta, endometritis, oft repeated pregnancy, or myoma. Obviously, there is no possibility of such a placenta separating itself normally, and manual extraction entails extreme danger of rupture of the uterus and hemorrhage. Dietrich, in 1922, found nineteen well described cases