As much as we would like to believe that the knowledge passed down through generations, along with advancements in medical science, gives us complete control over pregnancy, the reality is often more complex. Those who have experienced pregnancy know that even the most diligent adherence to expert advice doesn’t guarantee a smooth journey. There are still many unknowns regarding the factors that can affect pregnancy outcomes. This uncertainty can be particularly daunting, especially before the newborn care phase begins.
The intention here is not to instill fear, but rather to provide crucial information. If you or someone you know has been diagnosed with placenta accreta, understanding its symptoms, risks, treatment options, and management strategies is essential. Here’s what you need to know.
Symptoms of Placenta Accreta
Placenta accreta occurs when the placenta attaches too deeply into the uterine wall. According to medical sources, this condition can lead to two major complications: the placenta may not be delivered naturally after childbirth, and attempts to remove it can result in severe bleeding. Generally, there are no obvious symptoms of placenta accreta during pregnancy; however, if symptoms do occur, they often present as vaginal bleeding during the third trimester.
Causes of Placenta Accreta
Researchers haven’t identified a single cause for placenta accreta, but many individuals with this condition have abnormalities in the uterine lining, often due to scarring from previous C-sections or uterine surgeries. Nonetheless, not all individuals with placenta accreta have such scarring. Other potential risk factors include:
- Placenta Position: If the placenta is located low in the uterus or covers the cervix (known as placenta previa), the risk for placenta accreta increases.
- Maternal Age: Women over 35 are at a higher risk.
- Previous Pregnancies: The likelihood increases with each subsequent pregnancy.
Types of Placenta Accreta
There are two other classifications of placenta accreta based on how deeply the placenta is embedded in the uterus:
- Placenta Increta: The placenta attaches to the uterine wall and connects to the muscle but does not penetrate it.
- Placenta Percreta: This is the most severe form, wherein the placenta grows through the uterine wall and may affect surrounding organs.
Diagnosis of Placenta Accreta
Placenta accreta may occasionally be detected during routine ultrasounds, but it is more commonly diagnosed just before or during delivery. If there is a suspicion of placenta accreta during pregnancy, it can often be confirmed through ultrasound. In some cases, an MRI may be utilized for further evaluation. While not all cases are diagnosed before delivery, this doesn’t necessarily affect the outcome; many individuals diagnosed with placenta accreta can still have a standard delivery.
Treatment of Placenta Accreta
Treatment varies based on the timing of the diagnosis and the severity of the condition. Surgical intervention is the most common approach, which may involve the removal of all or part of the placenta. There are different methods for placenta removal, including:
- Cord Traction: The placenta is gently massaged out of the uterus, typically preferred due to reduced blood loss and shorter hospital stays.
- Manual Removal: The doctor manually extracts the placenta from the uterine wall through hand movements.
If diagnosed early and the case is serious, a C-section may be scheduled, followed by a hysterectomy to prevent potentially life-threatening bleeding during placental separation. If a hysterectomy is performed, the ovaries are usually preserved to avoid premature menopause.
Consequences of Retained Placenta
It’s critical to remove the placenta after delivery. If retained, the uterus cannot contract properly, leading to potential hemorrhage. The placenta should ideally be expelled within 30 minutes of birth; failure to do so can result in complications, including scarring, the need for transfusions, or even a hysterectomy, which can be fatal if not addressed promptly.
For more information on related topics, check out our other blog post on home insemination and visit Make a Mom for fertility supplements. For additional resources on pregnancy and home insemination, Mount Sinai offers excellent guidance.
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