Deep Attachment of Placenta in Pregnancy- Complications and Treatment of Placenta Accreta
Fortunately, the majority of the pregnancy goes with pleasant routine. Most of the women go home happy and determined to start a successful family. But once in a while, a delivery that might seem going smoothly at first can all of a sudden become complicated for a number of reasons. One such complication is placenta accreta that might demand immediate medical attention.
Placenta Accreta by the term refers to a condition in pregnancy in which blood vessels and parts of placenta get attached too deeply into the uterine wall. Normally, after childbirth, the placenta detaches from the uterine wall within around half an hour after birth. But in placenta accreta, part or complete placenta remains firmly attached resulting in severe blood loss after delivery. It is estimated that 1 in 2,500 pregnancies end up in developing placenta accreta.
In some other cases, the placenta attached so deeply that it grows through the uterine muscles (placenta increta) or even through uterine wall (placenta percreta). Cases of placenta increta and placenta percreta account for 15 percent and 5 percent respectively. Placenta accreta is a high-risk complication and if suspected during pregnancy, would demand caesarean delivery. The c-section delivery will be followed by hysterectomy, a procedure which removes the uterus.
What causes Placenta Accreta?
The exact cause of placenta accreta is still unknown. But doctors relate it to existing abnormalities in the uterine lining that occurs due to scarring after cesarean delivery or some other uterine surgery. This can let placenta grow deeply into the uterine wall and cause the problem.
Pregnant women, whose placenta partly or completely covers their cervix (placenta previa) are also at high risk of developing placenta accreta. It is estimated that 5-10 percent cases of placenta previa would develop placenta accreta. Maternal age above 35 is also considered a risk factor.
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Are there any symptoms of Placenta Accreta?
This condition often causes no signs or symptoms. However, there are some possible indicators in the third trimester (27-40 weeks) such as vaginal bleeding. Placenta accreta is often detected during a routine ultrasound. So talk to the gynaecologist if you spot any vaginal bleeding during the third trimester.
Complications of Placenta Accreta
Placenta accreta can cause severe complications. Some of them include:
- Serious vaginal bleeding (haemorrhage) which may need blood transfusion
- Blood clotting problem or disseminated intravascular coagulopathy
- Lung failure
- Kidney failure
- Premature delivery
Diagnosis of Placenta Accreta
The condition can be diagnosed if the doctor suspect of placenta previa during pregnancy. He may suggest following tests:
- Ultrasound to see how the placenta is implanted in the uterine wall
- Blood tests to check unusual rise of alpha-fetoprotein, a protein produced by baby and detected in mother’s blood
How Placenta Accreta is Treated?
If the doctors are able to diagnose placenta accreta, the foremost goal of the team would be to deliver the baby safely. Early detection of the condition will let the team of doctor create a plan with scheduled cesarean delivery as early as 34 weeks. This would balance baby’s health with mother’s health.
Serious cases of placenta accreta will require surgery. The doctor will first perform a c-section delivery and next goal will be to remove the uterus (hysterectomy). This is needed to prevent severe blood loss and save the life of the mother.
After the removal of the uterus (hysterectomy), you will no longer be able to conceive in future. However, if the condition is diagnosed and properly treated, the woman has the chance of making full recovery without any future complications.
You can also consult your gynecologist and explore your options for getting pregnant again. They could pick up a treatment plan depending on individual circumstances.