What Is Placenta Accreta? All You Should Know About This Pregnancy Condition
This rare but very serious pregnancy complication is becoming more popular.
What is placenta accreta? In most pregnancies, the placenta easily detaches from the wall of the uterus after delivery. But in some rare cases, the placenta grows too deeply into the wall of the uterus and becomes inseparable. This serious pregnancy complication is placenta accreta. This article contains relevant information about the causes, symptoms, and risk factors of this condition. And what your doctor may do if you are diagnosed with placenta accreta.
What Is Placenta Accreta?
The placenta is an organ that forms in your uterus during pregnancy. It supplies oxygen and nutrients to your baby. As it grows, the placenta attaches to the uterus wall. In some rare cases (in about 1 in every 533 pregnancies) the placenta grows too deeply into the uterine wall. And so it doesn't get detached after your baby is born. Experts call this condition placenta accreta.
What Can Happen If You Have Placenta Accreta?
This is a serious condition that could lead to life-threatening amounts of vaginal bleeding (haemorrhage) after you give birth. This can happen if part of the placenta remains attached to the uterine wall, while the rest tears away during delivery.
The heavy vaginal bleeding associated with this condition can prevent the blood from clotting as it normally would. It can also lead to lung and kidney failure.
This deadly condition increases the risk of premature labour.
If the condition causes you to start bleeding during your pregnancy, you might be required to deliver your baby early via cesarean section.
If your doctor diagnoses the condition, you will have lots of questions about what might happen. Your doctor will answer all of your questions; he'll make a plan to ensure you and your baby are kept safe, and lower the risk of complications.
Types of Placenta Accreta
Placenta accreta is the general term to describe this condition, but there are three specific types of this condition:
- Placenta accreta. The placenta firmly attaches to the wall of the uterus, but does not pass through the wall or impact the muscular wall of the uterus.
- Placenta increta. The placenta is more deeply embedded in the wall of the uterus and also firmly attaches to the muscular wall of the uterus.
- Placenta percreta. The placenta extends through the wall of the uterus and muscles and, in some cases, attaches to other nearby organs such as the bladder or intestines.
What Causes The Condition?
It’s not clear what triggers the condition. In some cases, experts think it is related to abnormalities in the lining of the uterus. And these are often due to scarring after a cesarean section or another uterine surgery. Keep in mind, this condition can happen even if you haven’t had any kind of uterine surgery before.
Symptoms of Placenta Accreta
There are often no signs or symptoms during pregnancy. In some cases, though, bright red vaginal bleeding without pain during the third trimester or a little earlier could be a sign.
This type of bleeding may also be a sign of placenta previa. This is when the placenta lies low in the uterus and covers all or part of the cervix. Speak to your doctor right away if you notice any vaginal bleeding during your pregnancy.
Although it’s not always known what causes placenta accreta, risk factors include:
- Uterine surgery. Any kind of surgery on the uterus that has caused damage to the myometrium, which is the muscle wall of the uterus, increases the risk of placenta accreta. Surgeries that cause scarring to the uterus include a cesarean section, the surgical removal of fibroids that are inside the uterus wall, uterine artery embolization, and endometrial ablation.
- One or more previous pregnancies. The risk for placenta accreta increases with each pregnancy.
- Being more than 35 years old.
- The position of the placenta. If you have placenta previa, your risk of placenta accreta increases.
In the past, placenta accreta often wasn’t diagnosed until after the baby was delivered. In some cases, this can still happen, but it’s now most often diagnosed during pregnancy with an ultrasound scan.
This is good news, because an early diagnosis means your healthcare provider can try to prevent or better prepare for complications, such as heavy bleeding.
If you have any of the risk factors, your healthcare provider will more carefully watch for placenta accreta. And if the results of the ultrasound aren’t clear, he may order a magnetic resonance imaging (MRI) done.
If you get a diagnosis, your doctor will give you guidance about how you and your baby will be kept safe throughout your pregnancy and delivery.
There's no cure for this condition during pregnancy; but the risks associated with it can be managed.
If you get an early diagnosis, treatment typically involves a planned cesarean section to deliver your baby, followed by a hysterectomy. A hysterectomy is when doctors surgically remove all or part of the uterus. In some cases, it may be possible to avoid having a hysterectomy. Your healthcare provider will discuss all of your options with you.
Depending on what your healthcare provider thinks is the safest, he may schedule your cesarean section early. Or he puts it off until your pregnancy is full term. In some cases, you may need an emergency cesarean section if unexpected issues arise.
Your healthcare provider may offer or recommend an amniocentesis test. This test can help your provider determine the best timing for the cesarean, as it can help assess whether your little one’s lungs are mature enough for birth.
In some cases, your doctor may give you corticosteroids; to speed up the development of your baby’s lungs and other organs. This helps protect your baby should your provider think an early cesarean delivery is safest.