Placenta accreta
Normally, the
placenta is attached to the wall of the uterus, but there is a condition when
the placenta is attached to the wall of the uterus too deeply. This condition
is known as placenta
accreta, placenta increta, or placenta percreta, depending on the severity and depth of placental
attachment. Approximately 1 in 2500 pregnancies has placental accreta,
placental accreta, or placenta accreta.
What is the difference between accreta, increta or percreta?
The difference
between placenta accreta, increta or percreta is determined by the severity of
the attachment of the placenta to the uterine wall.
Placenta accreta
occurs when the placenta attaches too deeply to the wall of the uterus but does
not penetrate the muscles of the uterus and is the most common occurrence,
accounting for about 75% of all cases.
Placenta increta
occurs when the placenta attaches even deeper to the uterine wall and enters
the uterine muscle. Placenta increta accounts for about 15% of all cases.
Placenta percreta occurs
when the placenta penetrates the entire wall of the uterus and attaches to
another organ, such as the bladder. Placenta percreta is the least common of
the three conditions, accounting for about 5% of all cases.
What causes placenta accreta?
The specific cause of
placenta accreta is unknown, but it may be related to placenta previa and a
previous caesarean section. It is present in 5-10% of women with placenta
previa.
A caesarean section
increases the chance of future placenta accreta, and the more caesarean
sections there are, the greater the increase. Multiple caesarean section
occurred in more than 60% of cases.
What are the risks of placenta accreta for the baby?
Premature birth and
the complications that arise from them are the main concerns of the baby.
Bleeding in the third trimester can be a warning sign that placenta accreta is
present, and when placenta accreta does occur, it usually results in preterm
labor.
Your doctor will
check your condition and administer medications, bed rest, and whatever else is
needed to help carry your pregnancy.
What are the risks of placenta accreta for the mother?
The placenta usually
does not separate well from the uterine wall. The main problem for the mother
is bleeding during manual attempts at separation of the placenta. Severe
bleeding can be life-threatening.
Other problems are
associated with damage to the uterus or other organs (percreta) during removal
of the placenta. Hysterectomy is a common therapeutic intervention, but the
result is loss of the uterus and the ability to conceive.
How is it treated?
There is nothing a
woman can do to prevent placenta accreta, and there is little that can be done
to treat it once it has been diagnosed. Once diagnosed, your doctor will
monitor your pregnancy to determine the time of delivery and use surgery that
can save the uterus.
It is especially important to discuss this surgery with your doctor if you want to have other children.