Placenta Accreta: Causes, Symptoms, Risk Factors, Diagnosis, Treatment and Complications

Placenta accreta is a dangerous pregnancy condition that develops when the placenta grows too deeply in the uterine wall.

Normal placental separation from the uterine wall occurs after delivery. Placenta accreta is a condition in which all or a portion of the placenta is still attached. This may cause significant blood loss upon delivery.

A placenta increta occurs when the placenta invades the uterine muscles, as opposed to a placenta percreta, which occurs when the placenta grows through the uterine wall.

Causes Of Placenta Accreta

The abnormalities in the uterine lining are thought to be responsible for placenta accreta which are generally caused by scarring after C-sections or other uterine surgeries. However, placenta accreta can occasionally develop without any prior uterine surgery.

Symptoms Of Placenta Accreta

Despite the risk of vaginal bleeding during the third trimester, pregnancy placenta accreta commonly remains unnoticed.

A typical ultrasound may occasionally show placenta accreta.

Risk Factors Of Placenta Accreta

Placenta accreta risk can be affected by a variety of circumstances, such as:

• Previous uterus surgery: The more C-sections or other uterus procedures you've had, the higher your chance is for placenta accreta.

• Position of the placenta: You are more likely to develop placenta accreta if the placenta partially or completely covers your cervix (placenta previa) or resides in the lower section of your uterus.
• Age of the mother: Women above the age of 35 are more likely to experience placenta accreta.
• Previous childbirth: As your number of pregnancies rises, so does the chance of placenta accreta.

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Diagnosis Of Placenta Accreta

Your doctor will carefully inspect the implantation of your baby's placenta if you have any preexisting conditions that could lead to placenta accreta, such as placenta previa, in which the placenta partially or completely covers the cervix.

Your healthcare professional can assess the depth of the placenta's implantation in your uterine wall using an ultrasound or magnetic resonance imaging (MRI).

Treatment Of Placenta Accreta

In the event that placenta accreta is suspected, your healthcare professional will work together with you to create a plan for the safe delivery of your child.

A C-section followed by a hysterectomy may be required if there has been substantial placenta accreta. This surgery, also known as a caesarean hysterectomy, helps prevent the possibly fatal blood loss that can happen if the placenta is attempted to be separated.

Your doctor could advise pelvic rest or hospitalisation if you experience vaginal bleeding in the third trimester.

Before surgery

Your obstetrician and gynaecologist will be a part of your medical team, along with pelvic surgery subspecialists, an anaesthesia team, and a paediatric team.

Your healthcare provider will discuss the risks and possible problems related to placenta accreta. He or she might also discuss the possibility of you:

• Undergoing blood transfusions before, during, or after delivery.
• Life-threatening haemorrhage after birth requiring admission to the intensive care unit.

During an operation

Your doctor will make a first incision in your abdomen and a second one in your uterus to deliver your baby during a C-section. To avoid serious bleeding following birth, a member of your medical team will remove your uterus while the placenta is still within.

You are unable to become pregnant after a hysterectomy. Discuss your alternatives with your healthcare physician if you want to become pregnant again in the future.

Rarely, the uterus and placenta may be preserved, allowing the placenta to degrade over time. However, this strategy may lead to significant problems, such as:

• Severe vaginal bleeding
• Infection
• A future requirement for a hysterectomy

Limited data also suggests that women who are able to postpone hysterectomy after developing placenta accreta may be more susceptible to problems, such as recurrent placenta accreta, in subsequent pregnancies.

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Complications Of Placenta Accreta

Placenta Accreta can result in:

• Heavy vaginal bleeding: After delivery, a placenta accreta dramatically increases the risk of severe vaginal bleeding (haemorrhage). Disseminated intravascular coagulopathy, adult respiratory distress syndrome, kidney failure, and lung failure are among potentially fatal conditions that can result from bleeding. 
• Premature birth: Labour could start early due to placenta accreta. You might need to have your baby delivered early if placenta accreta results in bleeding during your pregnancy.

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