Placenta accreta

Placenta accreta

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What is placenta accreta?

Placenta accreta is a high-risk pregnancy complication that happens when the placenta becomes embedded too deeply in the uterine wall.

Normally, a few minutes after you deliver your baby, the placenta detaches from the wall of your uterus and is delivered as well. When you have placenta accreta, the placenta remains attached to the uterine wall. This can cause severe bleeding.

If your healthcare provider suspects you have placenta accreta, you may need to have an early c-section followed by a hysterectomy (surgical removal of your uterus).

Placenta accreta has become more common as the c-section rate has gone up over the last 50 years. (A previous c-section is a risk factor for placenta accreta.) The condition now affects about 1 in 600 births in the United States each year.

Similar but less common problems include placenta increta, in which the placenta is embedded in the muscles of the uterus, and placenta percreta, in which the placenta grows through the uterine wall and sometimes into nearby organs. Together, placenta increta, placenta percreta, and placenta accreta are known as placenta accreta spectrum.

Signs and symptoms of placenta accreta

Placenta accreta often has no symptoms. As a result, sometimes you don't even know you have it until you deliver your baby. In other cases, your provider sees signs of it in an ultrasound. And vaginal bleeding during the third trimester can be a warning sign.

If you have vaginal bleeding during your third trimester, contact your healthcare provider immediately. If the bleeding is severe, call 911 or go to the emergency room.

If your provider suspects you have placenta accreta, an ultrasound or an MRI may be done to try and see how the placenta is implanted in your uterine wall. (These tests are painless and safe for you and your baby.)

Your blood may also be tested for a rise in alpha-fetoprotein. This protein is produced by your baby, and the amount tends to increase if you have placenta accreta.

Treatment for placenta accreta

If placenta accreta seems likely, your provider may want to schedule a c-section, followed by the removal of your uterus with the placenta still attached. This should prevent life-threatening bleeding.

In rare cases, certain techniques can be used to control the bleeding and allow you to keep your uterus. If you're hoping to have another child, talk to your provider about your options ahead of time.

Placenta accreta can be problematic if you go into premature labor. So your c-section may have to be scheduled as early as 34 weeks to avoid an unscheduled emergency delivery.

You'll need to deliver at a hospital that has an intensive care unit and is equipped to handle severe bleeding. Your healthcare team may include a maternal-fetal medicine specialist (MFM), an obstetrical surgeon, a pelvic surgeon, and an anesthesiologist, as well as a neonatologist to care for your premature baby.

If your uterus is removed, you won't be able to get pregnant again. If you want more children, you may decide to adopt or use a surrogate.

Undetected placenta accreta

Sometimes it's difficult to detect a placenta accreta until you've delivered your baby and it's time to deliver the placenta. If your placenta doesn't detach from the uterine wall and you have heavy bleeding, accreta may be the cause.

This situation can be life-threatening. You may need multiple blood transfusions and a hysterectomy to control the bleeding.

Risk factors for placenta accreta

These can raise your risk of placenta accreta:

  • A previous c-section or other uterine surgery. Your risk of placenta accreta goes up with each uterine surgery, including surgery to remove fibroids. (This is one reason it's not a good idea to have a c-section for nonmedical reasons.)
  • Placenta previa. The biggest risk factor is placenta previa following a previous cesarean delivery, but placenta previa with no prior c-section is also a risk factor
  • How many babies you've delivered. The risk of placenta accreta increases each time you give birth.
  • Certain other uterine conditions. The risk of placenta accreta is higher if you have uterine fibroids or scarring in the tissue that lines your uterus.
  • Cigarette smoking. Smoking raises the risk of placental problems.
  • Your age. Placenta accreta is more common in women 35 and older.
  • Infertility and some infertility procedures. Cryoreserved embryo transfer during IVF is a strong risk factor for accreta.

Support and more information

Talk to others in the our site Community who are pregnant now or have been through childbirth with placenta accreta, increta, or percreta.

Learn more about placenta accreta at National Accreta Foundation.

Watch the video: Jennys Story: Placenta Accreta Video - Brigham and Womens Hospital (May 2022).

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