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Placenta accreta

Medically reviewed by Drugs.com. Last updated on Jun 3, 2022.

Overview

Placenta accreta is a serious pregnancy condition that occurs when the placenta grows too deeply into the uterine wall.

Typically, the placenta detaches from the uterine wall after childbirth. With placenta accreta, part or all of the placenta remains attached. This can cause severe blood loss after delivery.

It's also possible for the placenta to invade the muscles of the uterus (placenta increta) or grow through the uterine wall (placenta percreta).

Placenta accreta is considered a high-risk pregnancy complication. If the condition is diagnosed during pregnancy, you'll likely need an early C-section delivery followed by the surgical removal of your uterus (hysterectomy).

Placenta accreta

Placenta accreta occurs when the placenta grows too deeply into the uterine wall during pregnancy. Scarring in the uterus from a prior C-section or other uterine surgery may play a role in developing this condition.

Symptoms

Placenta accreta often causes no signs or symptoms during pregnancy — although vaginal bleeding during the third trimester might occur.

Occasionally, placenta accreta is detected during a routine ultrasound.

Causes

Placenta accreta is thought to be related to abnormalities in the lining of the uterus, typically due to scarring after a C-section or other uterine surgery. Sometimes, however, placenta accreta occurs without a history of uterine surgery.

Risk factors

Many factors can increase the risk of placenta accreta, including:

Complications

Placenta accreta can cause:

Diagnosis

If you have risk factors for placenta accreta during pregnancy — such as the placenta partially or totally covering the cervix (placenta previa) or a previous uterine surgery — your health care provider will carefully examine the implantation of your baby's placenta.

Through an ultrasound or MRI, your health care provider can evaluate how deeply the placenta is implanted in your uterine wall.

Treatment

If your health care provider suspects placenta accreta, he or she will work with you to develop a plan to safely deliver your baby.

In the case of extensive placenta accreta, a C-section followed by the surgical removal of the uterus (hysterectomy) might be necessary. This procedure, also called a cesarean hysterectomy, helps prevent the potentially life-threatening blood loss that can occur if there's an attempt to separate the placenta.

If you have vaginal bleeding during the third trimester, your health care provider might recommend pelvic rest or hospitalization.

Before surgery

Your health care team will include your obstetrician and gynecologist, subspecialists in pelvic surgery, an anesthesia team, and a pediatric team.

Your health care provider will discuss the risks and potential complications associated with placenta accreta. He or she might also also discuss the possibility of your:

During surgery

During your C-section, your health care provider will deliver your baby through an initial incision in your abdomen and a second incision in your uterus. After the delivery, a member of your health care team will remove your uterus — with the placenta still attached — to prevent severe bleeding.

After a hysterectomy, you no longer can become pregnant. If you had planned additional pregnancies in the future, discuss possible options with your health care provider.

Rarely, the uterus and placenta might be kept intact, allowing the placenta to dissolve over time. However, this approach can have serious complications, including:

In addition, limited research suggests that women who are able to avoid hysterectomy after having placenta accreta are at risk of complications, including recurrent placenta accreta, with later pregnancies.

Coping and support

If your health care provider suspects that you have placenta accreta, you'll likely worry about how your condition will affect your delivery, your baby and, possibly, future pregnancies.

To ease your anxiety:

Preparing for your appointment

If you have vaginal bleeding during your third trimester, contact your health care provider right away. If the bleeding is severe, seek emergency care.

Often, placenta accreta is suspected after an ultrasound early in pregnancy. You can learn about the condition and develop a plan to manage it at a follow-up visit.

What you can do

Before your appointment, you might want to:

Some questions to ask your health care provider about placenta accreta include:

Don't hesitate to ask other questions as they occur to you during your appointment.

What to expect from your doctor

Your health care provider is likely to ask you questions, such as:

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