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Knowing what causes it, symptoms to look out for, and how it’s treated can give you peace of mind and prepare you for discussions with your doctor.
What is Placenta Accreta?
Placenta accreta is a pregnancy complication where the placenta attaches too deeply to the uterine wall and fails to separate naturally. In a normal pregnancy, the placenta is usually expelled from the uterus after your baby is born. But in this case, the placenta remains attached. This can cause serious issues, like heavy bleeding after delivery. It’s considered a high-risk condition because it can lead to life-threatening complications for you.Types of Placenta Accreta
There are three different types of placenta accreta, classified based on how deeply the placenta embeds into your uterus:- Placenta Accreta: The placenta attaches firmly to the uterine wall but doesn’t penetrate the muscle layer. This is the most common type and makes up the majority of cases.
- Placenta Increta: The placenta embeds deeper into the uterine wall, reaching the muscle layer but not passing through it.
- Placenta Percreta: The most severe form, where the placenta grows through the uterine wall and may even affect nearby organs like the bladder or intestines.
Who is at Risk for Placenta Accreta?
Certain factors can increase your chances of developing placenta accreta. You’re at higher risk if you:- Have had one or more caesarean sections (C-sections), as scarring from these procedures increases the chances.
- Have a history of other uterine surgeries, such as fibroid removal or procedures like curettage or endometrial ablation.
- Have placenta previa, where the placenta covers part or all of your cervix.
- Had multiple pregnancies, as the risk grows with each pregnancy.
- Are pregnant through in vitro fertilisation (IVF).
- Are over 35 years old, as maternal age can play a role.
Causes of Placenta Accreta
The exact cause of placenta accreta isn’t fully understood, but it’s often linked to abnormalities in the lining of your uterus. These abnormalities are usually due to scarring from previous uterine surgeries, like C-sections or fibroid removal. The scarring can create an environment where the placenta grows too deeply into the uterine wall. In some rare cases, placenta accreta occurs even without a history of uterine surgery.Placenta previa also significantly increases the risk, and the more C-sections you’ve had, the higher the chance of developing this condition.Symptoms of Placenta Accreta
One of the tricky things about placenta accreta is that it often doesn’t cause noticeable symptoms during pregnancy. Most individuals find out they have it through routine medical imaging rather than experiencing specific signs. However, in some cases, you might notice:- Vaginal bleeding in the third trimester (weeks 28 to 40).
- Pelvic pain, which could happen if the placenta presses on nearby organs like your bladder.
How Placenta Accreta Affects You and Your Baby
Placenta accreta doesn’t directly harm your baby, but it can lead to challenges for both of you. The main concern for your baby is preterm birth, as doctors might recommend early delivery to prevent any complications. Babies born before 37 weeks may face issues like:- Respiratory problems.
- Difficulty gaining weight.
- A need for specialised care in the neonatal intensive care unit (NICU).
- Heavy vaginal bleeding after delivery, which may require a blood transfusion.
- Damage to your uterus or nearby organs.
- Loss of fertility if a hysterectomy is needed.
- Blood clotting problems like disseminated intravascular coagulopathy (DIC).
- Rare but severe outcomes, such as lung or kidney failure, or even death.
How Common is Placenta Accreta?
Placenta accreta syndrome is considered rare but is becoming increasingly common due to rising caesarean delivery rates. A research study conducted at a hospital in Pune found the incidence to be 4.3 per 10,000 deliveries. It also revealed that placenta accreta syndrome occurred more often in younger individuals, with a mean age of 27 years.The increase in surgical deliveries has made this condition a more frequent concern in modern obstetrics.Diagnosing Placenta Accreta
Early diagnosis is important to manage placenta accreta effectively. It can be identified by the following methods:- Ultrasound: A routine prenatal ultrasound is the most common way to detect this condition. It can show signs of abnormal placental attachment.
- Magnetic resonance imaging (MRI): If the ultrasound isn’t clear, an MRI may be used to get a better look at how deeply the placenta is embedded in your uterine wall.
- Post-delivery diagnosis: In some cases, placenta accreta isn’t discovered until after childbirth. It is detected when the placenta doesn’t detach within 30 minutes of delivery as expected.
Treatment Options for Placenta Accreta
If you’re diagnosed with placenta accreta, your doctor will work with you to create a plan for a safe delivery. Treatment depends on the severity of the condition and your plans for future pregnancies. A few common treatment options include:- Close monitoring: If diagnosed during pregnancy, your doctor will keep a close eye on your health. You may need to be hospitalised or put on bed rest to prevent preterm labour.
- Planned caesarean section: Most individuals with placenta accreta will have a C-section scheduled between 34 and 37 weeks of gestation to avoid excessive bleeding during labour. Your doctor may give you corticosteroids to help your baby’s lungs develop before delivery.
- Hysterectomy: In severe cases, especially with placenta increta or percreta, a caesarean hysterectomy (removing the uterus during the C-section) may be necessary to prevent life-threatening haemorrhage. This involves delivering your baby, uterus, and placenta together.
Can You Prevent Placenta Accreta?
Unfortunately, there’s no way to prevent placenta accreta. The condition is closely tied to factors like previous C-sections or placenta previa, which can’t always be avoided. If you have a history of these risk factors, talk to your doctor about your chances of developing this condition. They can help you understand your risks and monitor your pregnancy closely.Questions to Ask Your Doctor
It’s normal to feel worried and have questions if you’re diagnosed with placenta accreta. These are some questions you might want to ask your doctor:- Will I need to deliver my baby early?
- What treatment options are available for me?
- Do I need to modify my daily activities or go on bed rest?
- How will I know when it’s time to go to the hospital?
- Is a vaginal delivery possible with my condition?
- Will I be able to have more children in the future?
- Is a hysterectomy likely in my case?
FAQs on What is Placenta Accreta? Everything to Know About This High-Risk Pregnancy Condition
- Who is most at risk of developing placenta accreta?People with prior C-sections, uterine surgeries, placenta previa, multiple pregnancies or those over 35 are at higher risk.
- How is placenta accreta diagnosed?It’s usually diagnosed through a prenatal ultrasound or MRI. In some cases, it’s discovered after delivery if the placenta doesn’t detach.
- What complications can arise from placenta accreta?It can cause heavy bleeding, organ damage, blood clots, and the need for a hysterectomy.