Overview
Placenta accreta is a pregnancy complication where the placenta grows too deeply into the uterine wall, instead of detaching after childbirth as it typically does. When the placenta remains attached, it can cause severe bleeding after delivery, making it a high-risk condition. In some cases, the placenta may invade the muscles of the uterus (placenta increta) or grow through the uterine wall (placenta percreta). Placenta accreta can be life-threatening and requires early delivery and surgical removal of the uterus (hysterectomy).
Understanding the disease
Symptoms
The symptoms of placenta accreta are often mild or absent during pregnancy. However, in some cases, vaginal bleeding may occur during the third trimester. Placenta accreta can cause severe bleeding after delivery, which can lead to life-threatening complications. Other possible complications include disseminated intravascular coagulopathy, adult respiratory distress syndrome, and kidney failure. If you suspect you may have placenta accreta, consult a healthcare professional for proper evaluation and management.
Risk Factors
The risk factors for developing placenta accreta include:
- Previous uterine surgery, such as C-sections or other procedures.
- Placenta position, such as placenta previa or a low-lying placenta.
- Maternal age, as placenta accreta is more common in women over 35.
- A history of previous childbirths, as the risk increases with the number of pregnancies.
Development
Placenta accreta, placenta increta, and placenta percreta are different forms of abnormal placentation.
- Placenta accreta: In placenta accreta, the placenta grows too deeply into the uterine wall, and parts of it remain attached even after childbirth. This can cause severe blood loss after delivery.
- Placenta increta: In placenta increta, the placenta invades the muscles of the uterus. This type of placentation can also cause severe bleeding after delivery and may require a hysterectomy.
- Placenta percreta: In placenta percreta, the placenta grows through the uterine wall and can invade other organs, such as the bladder or rectum. This type of placentation can cause life-threatening complications, including bleeding, organ damage, and infection. All three types are considered high-risk pregnancy complications and can lead to severe bleeding, hysterectomy, and other serious health issues. The development of these conditions is thought to be related to abnormalities in the lining of the uterus, typically due to scarring after a C-section or other uterine surgery. However, sometimes placenta accreta occurs without a history of uterine surgery.
Assessment and Diagnosis
Triage
If you suspect placenta accreta, it's important to see a doctor right away. Placenta accreta is a serious pregnancy condition that requires close monitoring and management. If you experience vaginal bleeding during the third trimester, contact your healthcare provider immediately, as it could be a sign of placenta accreta. In some cases, placenta accreta is detected during a routine ultrasound. If your healthcare provider suspects placenta accreta, they may perform additional tests to confirm the diagnosis and develop a plan for delivery and postpartum care.
Diagnosis
To diagnose placenta accreta, your health care provider will typically use one or more of the following methods:
- Ultrasound: This noninvasive diagnostic technique uses high-frequency sound waves to create images of the internal organs. During pregnancy, an ultrasound can help determine the location and implantation of the placenta.
- Magnetic Resonance Imaging (MRI): This diagnostic imaging technique uses a strong magnetic field and radio waves to produce detailed images of the body's internal structures. MRIs can provide a more accurate assessment of the depth and extent of placenta accreta.
- Placental biopsy: In some cases, your health care provider may perform a biopsy of the placenta. This involves taking a small sample of the placenta for laboratory analysis to confirm the diagnosis of placenta accreta. It's important to note that placenta accreta is often suspected after an ultrasound early in pregnancy. If your health care provider has identified risk factors or suspects placenta accreta, they will work with you to develop a plan to manage the condition and ensure a safe delivery. Remember to consult with your health care provider and discuss any concerns or questions you may have.
Management and Treatment
Complications
Placenta accreta can cause several potential complications, including:
- Heavy vaginal bleeding: Placenta accreta poses a significant risk of severe vaginal bleeding (hemorrhage) after delivery. The bleeding can lead to a life-threatening condition that prevents your blood from clotting normally (disseminated intravascular coagulopathy), as well as lung failure (adult respiratory distress syndrome) and kidney failure. A blood transfusion will likely be necessary.
- Preterm labor: Placenta accreta might cause labor to begin prematurely. If the condition causes bleeding during pregnancy, early delivery of the baby might be necessary.
- Hysterectomy: If placenta accreta is diagnosed during pregnancy, an early C-section delivery followed by the surgical removal of the uterus (hysterectomy) will likely be necessary. This can have long-term implications for future pregnancies and childbirth.
- Infertility: Removal of the uterus through hysterectomy eliminates the possibility of future pregnancies. It's essential to seek medical attention if you experience any symptoms or complications related to placenta accreta during pregnancy. Proper diagnosis and timely treatment can help minimize potential risks and complications.
Home Remedies
It's important to consult with a healthcare professional for proper diagnosis and management of placenta accreta.
Treatment
The primary treatment for placenta accreta is an early C-section delivery followed by the surgical removal of the uterus (hysterectomy). This is typically performed due to the risk of severe blood loss and potential complications associated with the condition. In some cases, if the placenta invades the muscles of the uterus (placenta increta) or grows through the uterine wall (placenta percreta), a hysterectomy may be recommended even before delivery. If the condition is diagnosed during pregnancy, the healthcare team will closely monitor the pregnancy and prepare for a timely delivery and hysterectomy.
Preparing for medical consultation
To prepare for an appointment for placenta accreta, you should:
- Ask about pre-appointment precautions: Inquire about any activities you should avoid and symptoms that should prompt you to seek urgent care.
- Bring a family member or friend: Have someone accompany you to the appointment to help you remember the information you receive.
- Write down questions: Prepare a list of questions to ask your healthcare provider about the condition, treatment options, and ongoing care.
- Learn about the condition: Familiarize yourself with placenta accreta by reading reliable sources or joining a support group.
- Identify support: Reach out to friends, family, or community organizations to find people who can provide emotional support or help with daily activities.
- Prepare for ongoing care: Discuss the plan for ongoing care and management with your provider, and ask about signs or symptoms that should prompt you to call or visit the hospital. Remember to communicate openly with your healthcare provider and share any concerns or questions you may have during the appointment.