What is placenta accreta?
Placenta accreta is a high-risk pregnancy complication where the placenta grows deep into the uterine wall and does not detach after childbirth. Women with placenta accreta may experience severe blood loss after a delivery.
What are the symptoms of placenta accreta?
While vaginal bleeding can occur, placenta accreta rarely shows signs or symptoms during pregnancy. If you have placenta accreta, you may not notice anything unusual.
What causes placenta accreta?
Placenta accreta is thought to be caused by scarring or other abnormalities with the lining of the uterus. These abnormalities may occur after procedures like C-section or fibroid removal.
Several risk factors may increase your risk of placenta accreta, including:
- Previous C-sections (Cesarean sections): Women who have had multiple C-sections are at a higher risk of developing placenta accreta.
- Placenta previa: Placenta previa is a condition where the placenta blocks the opening of the cervix. If you have placenta previa and have had C-sections, the risk for placenta accreta increases.
- History of fibroid removal: If you have had a fibroid (non-cancerous growth or tumor) removed from your uterine muscle, the scarring could lead to placenta accreta.
- Maternal age: Women older than 35 are more likely to have placenta accreta.
- Previous childbirth: The more pregnancies you’ve had, the higher your risk for placenta accreta.
What are the complications of placenta accreta?
Placenta accreta can cause serious complications, including:
- Heavy vaginal bleeding: There is a major risk of severe vaginal bleeding during pregnancy and after delivery. This heavy bleeding can cause life-threatening conditions related to abnormal blood clotting, lung function and kidney failure.
- Premature birth: You may need to deliver early if you begin to bleed during pregnancy.
How is placenta accreta diagnosed?
Placenta accreta can be detected using ultrasound or MRI. If you have one or more risk factors (like prior C-section), make sure your doctor is aware of your full medical history.
How is placenta accreta treated?
Because the placenta cannot be detached from the uterus after delivery, the definitive treatment is a hysterectomy. Due to the placenta’s ability to recruit nearby blood vessels (up to 15% of your blood flow), the risk for massive bleeding is very high.
At Loma Linda University Children’s Hospital, our expert team uses several advanced surgical techniques and technologies to reduce blood loss. These include bloodless uterine entry techniques, REBOA (resuscitative endovascular balloon occlusion of aorta), cell saver and special vessel sealing devices.
All cases of placenta accreta are a result of previous c-section
In rare cases, placenta accreta can develop if you haven’t had a c-section. It can be associated with in vitro fertilization (IVF), dilation and curettage (D&C) or uterine anomalies.
I do not have placenta accreta if the ultrasound says I don’t
There is no perfect imaging technique for diagnosing placenta accreta. Even in the most experienced hands, ultrasound can miss up to 10% of cases.
MRI is better than ultrasound at detecting placenta accreta
Most studies show that ultrasounds are better at detecting placenta accreta in the front of the uterus. MRI and ultrasound are equally good at identifying placenta accreta in the back of the uterus. MRI also has a higher tendency to make the disease look more severe than it actually is.