What is Placenta Accreta?

Placenta accreta is a pregnancy complication involving abnormal placental attachment to the uterine wall. It’s relatively rare, but according to the American College of Obstetricians and Gynecologists, it is becoming more common. 

In the 1970s and 1980s, the prevalence of the complication was 1 in every 2,510 births. Today it occurs in 1 in every 272 pregnancies.

The OB/GYNs at Maiden Lane Medical offer expert reproductive health care, including diagnosing and managing high-risk pregnancies and complications.

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What is placenta accreta?

Sometimes referred to as placenta accreta spectrum (PAS), the condition occurs when the placenta embeds too deeply into the uterine wall during pregnancy. The placenta is an organ that forms during pregnancy.

It surrounds the fetus and provides oxygen and nutrients during gestation. It also removes waste products and protects your growing baby.

PAS is a spectrum condition because of the three different depths that the placenta can reach. 

Placenta Accreta occurs when the placenta attaches too deep in the uterine wall, but it does not penetrate the uterine muscle.

Placenta Increta occurs when the placenta penetrates the uterine muscle.

Placenta Percreta occurs when the placenta pushes through the entire uterine wall and attaches to another pelvic organ such as the bladder. 

What causes placenta accreta?

Physicians and medical researchers haven’t identified a specific cause of PAS. However, there are links to placenta prevue and previous cesarean deliveries. Multiple cesarean deliveries can increase your risk of developing PAS in a future pregnancy. 

Other risk factors for PAS include:

  • Placenta previa and other abnormal placental placement
  • Advanced maternal age
  • Previous uterine surgery such as fibroid removal or endometriosis surgery
  • In vitro fertilization

Talk to your OB/GYN if you have any concerns about your risk of developing PAS. 

What are the symptoms of placenta accreta?

PAS doesn’t usually cause noticeable symptoms in its milder stages. However, if you have placenta percreta and the placenta embeds itself in a neighboring organ like the bladder, you may develop pelvic pain and find blood in your urine. 

Additionally, the condition often coincides with placenta previa, which can cause vaginal bleeding. In most cases, pregnant women don’t know they have PAS until they have an ultrasound and their OB/GYN notices the placental abnormality. 

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Who is at risk of this pregnancy complication?

Women who have had multiple cesarean deliveries have a high risk of PAS. Your risk also increases if you’re 35 or older or have had uterine procedures such as fibroid removal, endometriosis excision, or IVF. 

What complications does placenta accreta cause?

PAS can cause various complications for both the expecting mother and the baby.

Maternal complications

When PAS co-occurs with placenta previa or if there are attempts to detach the placenta from its embedded state, the mother-to-be has a risk of severe postpartum hemorrhage, which can be life-threatening. 

Vaginal births are not always possible when the expectant mother has PAS. This presents a specific risk if PAS isn’t diagnosed before labor and delivery. 

The OB/GYN must perform careful procedures to extract the placenta and control bleeding. The OB/GYN may recommend a cesarean delivery when diagnosed in advance. However, the doctor will need to remove the uterus after delivery in a worst-case scenario.

Fetal complications

PAS doesn’t directly harm the developing baby. The highest risk for babies is premature delivery. When an OB/GYN diagnoses PAS, they often suggest a cesarean delivery between 34-37 weeks. 

If the mother has severe bleeding, the OB/GYN may recommend delivery earlier. Premature babies usually need to spend time in the NICU.

How is placenta accreta diagnosed?

When you have your prenatal ultrasounds, your OB/GYN looks for signs of abnormalities and measures and monitors your baby’s development. If they see an indicator of PAS, they may order additional testing, such as a Doppler ultrasound. 

Doppler ultrasounds show blood flow, which provides more detail about abnormal placental embedding.

How is placenta accreta treated?

If you have PAS, you will have more frequent ultrasounds so your OB/GYN can monitor your condition. You may also need to have MRIs and consult with other specialists. In addition, your OB/GYN may strongly suggest having a cesarean delivery. 

They will need to remove the placenta surgically. If complications occur during the procedure, your surgeon may need to perform an emergency hysterectomy.

If you have PAS, it’s critical to find an OB/GYN with experience with the condition. The team at Maiden Lane Medical is experienced with PAS, placenta previa, and other complications. They’re committed to helping you and your baby have a safe gestation and delivery.

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