Placenta Accreta is a condition in which the placenta grows abnormally deep into the uterine wall tissue, causing the placenta to become embedded and at risk of placenta accreta after birth, which can cause severe postpartum bleeding and even death.
Placenta Accreta is usually asymptomatic, but doctors can detect abnormalities through ultrasound. The medical profession has not yet identified the exact cause and prevention of Placenta Accreta, but it can be treated in various ways to prevent possible harm after birth.
Symptoms of Placenta Accreta
People with placenta accreta often have no symptoms during pregnancy. Your doctor may detect the condition during a routine ultrasound. In some cases, you may experience vaginal bleeding in the third trimester, or between 27 and 40 weeks of pregnancy.
Normally, the placenta detaches from the uterine wall after childbirth. However, women with Placenta Acreta will have the placenta firmly embedded in the uterine wall even after childbirth. This can result in severe blood loss, placental abruption, or deep placental abruption throughout the thickness of the uterine muscle. Therefore, patients should see a doctor immediately if they experience severe vaginal bleeding, such as bleeding into a sanitary pad within a short period of time, or a large amount of bleeding accompanied by abdominal pain.
Causes of Placenta Accreta
Medical science has not yet identified the exact cause of Placenta Accreta, but it is suspected that it may be caused by scarring or other abnormalities in the uterine lining, and may be related to factors such as:
- CesareanSections: Having multiple cesarean sections may increase your risk of developing placenta accreta.
- Placenta previaoccurs when the placenta attaches to the lower part of the uterus and blocks the cervix. It is estimated that 5–10 percent of placenta previa cases occur in women with placenta previa.
- I had surgery to remove a uterine tumor and developed scarring in that area.
In addition, placenta accreta may be associated with the location of the placenta, previous uterine curettage, previous pregnancies, maternal age over 35, and women who have had surgery on the uterus, all of which may increase the risk of developing placenta accreta.
Diagnosis of Placenta Accreta
Placenta accreta is usually detected by a doctor on an ultrasound during pregnancy. In some cases, blood tests may be done to measure the levels of certain proteins, or imaging tests, such as an ultrasound or MRI, may be done to check the degree of attachment of the placenta to the uterine wall.
In addition, doctors will recommend that pregnant women undergo detailed placental implantation screening if they are at risk of placenta accreta, such as those with a low-lying placenta or those who have undergone uterine surgery.
Treatment of Placenta Accreta
If placenta accreta is suspected, the doctor and midwife will plan the delivery with the patient to ensure the safety of the baby. Patients with vaginal bleeding between 27 and 40 weeks of pregnancy are advised to be hospitalized or admitted.
In cases where a patient has a large area of placenta accreta, the doctor will perform a cesarean section and a hysterectomy at the same time to prevent death from excessive blood loss during the removal of the placenta from the uterus. Before the surgery, the specialist will discuss the risks and possible complications, as the patient may need to receive a blood transfusion during delivery or the patient may need to be closely monitored in the hospital after childbirth if the bleeding is severe.
During surgery, the surgeon performs a cesarean section first, then removes the uterus along with the still attached placenta. Most patients are unable to become pregnant after surgery. Only a small number of patients are able to keep the uterus with the attached placenta, and the placenta is allowed to gradually disintegrate on its own.
However, the abnormality that occurs may cause anxiety about childbirth, the health of the child or future pregnancy. Patients can reduce their anxiety by talking to a specialist to understand Placenta Accreta, preparing for a cesarean section and surgery, and taking care of themselves by doing activities to relax.
Complications of Placenta Accreta
Placenta Accreta can cause severe complications in patients, such as severe vaginal bleeding requiring blood transfusions, disseminated intravascular coagulation, pulmonary failure or respiratory distress syndrome (RDS), renal failure or premature birth, etc.
In addition, the surgical process can result in complications such as allergic reaction to anesthesia, blood clots, wound infection or injury to the wound, excessive bleeding, and damage to other organs.
If the doctor still keeps the uterus and lets the placenta gradually dissolve on its own, it can cause severe vaginal bleeding that is life-threatening, infection, blood clots in the coronary arteries in the lungs, or pulmonary embolism, which are risky to treat surgically and may affect future pregnancies.
Placenta Accreta Prevention
Placenta accreta is a condition that cannot be prevented, but early diagnosis of placenta accreta may help avoid hysterectomy and prevent death due to excessive blood loss. For women who have had a cesarean section or have a low-lying placenta, they should consult their doctor for close monitoring as they are at high risk of developing placenta accreta.
