A Case Report on Placenta Accreta: Developing a Conceptual Framework

Placenta accreta is a pathological condition of the placenta associated with multiple maternal and neonatal complications, but its diagnosis and treatment have been sparsely reported from the nursing viewpoint. This report describes a case of placenta accreta from the nursing perspective to develop a conceptual framework of care.

Our case involved a 37-year-old pregnant woman with four previous caesarean sections and a previous in vitro fertilisation. She was diagnosed with placenta accreta only in the operating theatre during a scheduled caesarean section, and she had not performed thorough antenatal care as in her previous pregnancies despite having significant symptoms, such as severe urinary incontinence. The patient experienced many complications during the caesarean section, including bladder injury, massive haemorrhage, and hysterectomy.

We develop a theoretical framework illustrating the core factors that influence the management of placenta accreta and associated maternal morbidities. This model highlights the distinction between patient characteristics, nurse characteristics, organisational factors, and pregnancy outcomes and shows their relationship to the diagnosis and prevention of placenta accreta. The model has important implications for research and practice, and the case reminds nurses of their recommended interventions to diagnose, manage, and prevent placenta accreta. The quality of care for placenta accreta cases should be promoted through the assessment of patients, nurses, and organisational factors and the application of prevention measures.