Placenta accreta

Overview

Placenta accreta is a pregnancy complication that happens when the placenta, responsible for the nutrients and oxygen of a developing fetus, attaches too deeply into the uterus and remains after delivery.

In a normal pregnancy, the placenta that grows in the uterus is separated from the uterine wall after giving birth and is pushed to the birth canal during labor contraction. It is when the placenta fails to detach from the uterine wall that a condition called placenta accreta occurs.

One major complication is heavy bleeding which can be life-threatening to the baby and the mother. However, when diagnosed early or before birth, risks can be managed. Healthcare provider may recommend a cesarean section (C-section) followed by a hysterectomy to prevent dangerous bleeding.

The risk associated with placental conditions depends on how deep the placenta has embedded in the uterus.

• Placenta increta: occurs when the placenta has attached firmly and affected the muscles in the uterus.
• Placenta percreta: the placenta has grown through the uterus and can impact nearby organs such as the intestine and bladder.

Symptoms

In some cases of placenta accreta, vaginal bleeding in the third trimester of pregnancy can happen. Bladder or pelvic pain may be felt in severe cases such as placenta percreta.

Generally, placenta accreta may not have visible signs and symptoms throughout the pregnancy. It is often diagnosed during a scheduled ultrasound.

Causes

Placenta accreta develops due to several reasons. Commonly, it can be from scarring after multiple C-sections or other uterine surgeries. Having these surgeries can cause damage in the uterine lining which increases the risk for placenta accreta. In some cases, placenta accreta may still develop even without having uterine surgery or known cause.

Risk factors

The following factors increases the risk of having placenta accrete:

• History: Having a previous surgical procedure for the uterus, such as multiple C-sections or other uterine surgeries increases the risk of placenta accreta.
• Age: Women who get pregnant at the age of 35 or above have a higher tendency of having placenta accreta.
• Position of the placenta: A higher chance of developing placenta accreta if the placenta is partially or completely covers the cervix (placenta previa) or it attaches in the lower segment of the uterus.