Placenta Accreta

Placenta accreta is a serious problem that can happen during pregnancy. Normally, after a baby is born, the placenta separates from the wall of the uterus (womb). But with placenta accreta, the placenta doesn't detach properly. Instead, it grows too deeply into the uterine wall. This means a significant portion, or even all, of the placenta stays attached.

This improper detachment can lead to a lot of bleeding after the baby is born. This is a serious concern because excessive bleeding can be life-threatening for both the mother and the baby.

There are different levels of placenta accreta. In placenta increta, the placenta grows into the muscle layer of the uterus. In placenta percreta, the placenta even grows through the uterine wall. These more severe forms can cause even more significant blood loss after delivery.

Placenta accreta is a condition where the placenta attaches too deeply to the uterus wall. Often, there are no noticeable problems during pregnancy. While some women might experience vaginal bleeding, especially late in pregnancy (during the third trimester), this isn't always the case.

Sometimes, a routine ultrasound scan during pregnancy can identify placenta accreta.

Placenta accreta is a condition where the placenta attaches too deeply to the wall of the uterus. This deep attachment is often linked to problems or scars in the uterine lining. These problems can be caused by past surgeries, like C-sections, that have left behind scar tissue. However, sometimes placenta accreta happens without any prior uterine surgery. In these cases, the cause is not as clear, and doctors are still learning more about why this happens.

Several things can make placenta accreta more likely. Placenta accreta is a condition where the placenta grows too deeply into the uterine wall.

• Past surgeries on your uterus: Having had a cesarean section (C-section) or other surgeries on your uterus increases your chances of placenta accreta. Each time you have a C-section, your risk goes up a bit. This is because the previous surgery can affect how the uterine lining grows.

• Where the placenta is located: If your placenta is partially or completely covering your cervix (called placenta previa), or if it's located in the lower part of your uterus, you have a higher risk of placenta accreta. The lower position of the placenta means it's more likely to implant deeply.

• Your age: Women over 35 are slightly more likely to develop placenta accreta than younger women. This is likely due to changes in the uterus as women age.

• Number of pregnancies: Having more pregnancies generally increases your risk of placenta accreta. Each pregnancy puts a little more stress on the uterine lining, which can potentially affect how the placenta attaches.

Placenta accreta is a serious condition where the placenta attaches too deeply to the uterus. This can lead to several complications:

• Heavy bleeding after delivery: A key problem with placenta accreta is the risk of very heavy bleeding (hemorrhage) after the baby is born. This bleeding can be life-threatening. The body might have trouble forming blood clots normally (a condition called disseminated intravascular coagulation, or DIC). This can also lead to problems like lung failure (adult respiratory distress syndrome, or ARDS) and kidney failure. A blood transfusion is often needed to replace lost blood.

• Early labor and delivery: Placenta accreta sometimes triggers labor to start too soon. If the bleeding from placenta accreta happens during pregnancy, it might mean your baby needs to be delivered earlier than expected.

If you have a higher chance of placenta accreta during pregnancy (like if your placenta is partially or completely over your cervix, or if you've had surgery on your uterus before), your doctor will closely monitor how your baby's placenta attaches to your uterus.

To see how deeply the placenta is growing into the uterine wall, your doctor will use an ultrasound or an MRI scan. This helps them understand the placement of the placenta.

If your doctor suspects placenta accreta, they'll work with you to create a safe delivery plan.

Placenta accreta is a condition where the placenta grows too deeply into the uterine wall. If the placenta is deeply embedded (extensive accreta), a C-section and removal of your uterus (hysterectomy) may be needed. This is called a Cesarean hysterectomy. It's done to prevent dangerous blood loss, which could happen if the placenta isn't removed carefully.

Heavy bleeding during the last three months of pregnancy (third trimester) might mean your doctor recommends resting or staying in the hospital.

Your medical team will include your obstetrician, gynecologist, pelvic surgery specialists, anesthesiologists, and a team to care for your baby if needed.

Your doctor will explain the risks and possible problems of placenta accreta. They might also talk about:

• Blood transfusions: You might need a blood transfusion during or after delivery.
• Intensive care: If you have severe bleeding, you might need to stay in the intensive care unit (ICU).
• More bleeding: You could experience a lot of vaginal bleeding.
• Infection: There's a risk of infection.
• Future hysterectomy: Sometimes, a hysterectomy might be needed later.

During a C-section for placenta accreta, your doctor will first cut open your abdomen, then your uterus, to deliver the baby. After the baby is born, a member of your medical team will remove your uterus, along with the attached placenta, to prevent heavy bleeding.

Having a hysterectomy means you can't get pregnant again. If you were hoping for more children, talk to your doctor about your options.

In very rare cases, the uterus and placenta might be left intact. The placenta would then dissolve over time. However, this approach carries significant risks, including:

• Severe vaginal bleeding
• Infection
• The need for a hysterectomy later

Additionally, some research suggests that women who avoid a hysterectomy after placenta accreta might have complications, like placenta accreta happening again, in future pregnancies.