Placenta Accreta

What is Placenta Accreta?

Placenta Accreta is a condition that occurs during pregnancy. During pregnancy, the placenta attaches to the wall of the uterus. However, when a woman has placenta accreta, the placenta attaches too strongly or deeply to the uterine wall. The severity of placenta accreta depends on how deeply the placenta gets embedded into the uterine wall.

Sometimes, in the most severe cases of this condition the placenta grows beyond or past the uterine wall. If this happens, it can also be referred to as placenta percreta and if the placenta goes into or through the uterine muscle, it is called placenta increta. When placenta accreta is not diagnosed before childbirth, uncontrollable and continued bleeding can occur after the child is born. This can be life-threatening.

The exact causes of placenta accreta are not known. However, if a woman has an abnormality with their uterine wall or lining already, they may be more prone to develop placenta accreta. Additionally, a previous cesarean delivery or a uterine surgery can result in scar tissue that can make a woman more prone to placenta accreta during future pregnancies.  Women over the age of 35 are also more prone to placenta accreta than other women.

What are the Symptoms of Placenta Accreta?

During a pregnancy, there are generally no symptoms of placenta accreta. However, there is a chance that this condition can be detected during a routine ultrasound. If it is detected during an ultrasound, doctors can be better prepared to protect the health of the child and mother during childbirth.

Sometimes, a woman with a placenta accreta may experience vaginal bleeding during her third trimester of pregnancy. Bleeding during the third trimester should always be taken very serious and warrant a visit to the emergency room or the ob/gyn.

Placenta Accreta Causes

Placenta Accreta is a serious, potentially life threatening condition that happens during pregnancy, when blood vessels of the placenta (along with other parts) adhere too intensely to the wall of a uterus. There is evidence that links placenta previa and past cesarean births to causing placenta accreta, although a specific determinant is not known. In typical conditions, the placenta will separate from a mother’s uterine wall after labor. Complications occur when a part of or the entire placenta remains securely attached, leading to severe blood loss. In some cases, the placenta can grow through the muscles of a uterus, placing a mother’s pregnancy at high risk. If a woman is diagnosed with placenta accreta, a very effective method for reducing bleeding (hemorrhage) is to perform a hysterectomy (removal of the uterus). This method of treatment is best used for large accretas, and it is important to know that there are other options other than a hysterectomy. The majority of mothers facing placenta accreta will need to have an early delivery, sometimes weeks prior to their delivery dates. Commonly, delivery of the baby would occur between 34 to 37 weeks of gestation.

How is Placenta Accreta Treated?

When a woman is diagnosed with placenta accreta before giving birth, a plan for a cesarean delivery can be developed. The baby will be delivered surgically to keep it safe. This situation also helps doctors to control the bleeding that occurs as a result of placenta accreta.

Oftentimes, a placenta accreta requires a hysterectomy to be successfully resolved. If a woman wishes to get pregnant again in the future, doctors can try to leave the placenta in the uterus. However, there are numerous risks to this including continued bleeding and serious infection.

Placenta Accreta Prevention

It is very important to talk to your doctor if you have been diagnosed with placenta accreta, as treatment and prevention of it is very minimal. Your doctor will make sure to monitor you and your baby, and schedule a surgery that may be able to save your uterus. Very rarely will your doctor, or team of surgeons present during labor, agree to let your uterus and placenta to stay complete with the intent of having the placenta diffuse over time. This has been shown to cause serious vaginal bleeding, infection, pulmonary embolism and the urgency for a future hysterectomy. It is common for women who have been diagnosed with placenta accreta to also have past cesarean births, as well as placenta previa. Your doctor may recommend c-sections as the safest delivery method for future pregnancies.