Placenta accreta is a serious, potentially life-threatening condition that occurs when the placenta grows too deeply into the uterine wall. Variations in placenta accreta exist such as placenta increta, a condition where the placenta grows into the muscle of the uterus, or placenta percreta, where the placenta can actually grow through the wall of the uterus and attach itself to other organs, increasing the risk of damage.
During pregnancy, the placenta grows inside the uterus, attached to the uterine wall, and supplies the baby with nutrition and oxygen through the umbilical cord. Right after delivery, normally the placenta separates easily from the uterus. However, in patients with placenta accreta, it's extremely hard to remove and can result in massive hemorrhage.
To minimize the risk of life-threatening heavy bleeding, patients diagnosed with placenta accreta are delivered several weeks ahead of the due date by planned cesarean section. A hysterectomy, which is the surgical removal of the uterus, is conducted immediately following delivery.
A rise in cesarean sections (more than 1 in 3 pregnancies in the United States) has contributed to a substantial increase in the number of women diagnosed with this medical condition. Experts cite placenta accreta as one of the contributors to the increased maternal mortality rate in the United States over the past decade.
Who is at risk?
Roughly 1 in 530 births in the United States involve placenta accreta. The coexistence of a previous cesarean delivery and placenta previa increase the chance of a placenta accreta. Placenta previa is a condition in which the placenta covers the mother's cervix, partially or completely. Women with placenta previa even without a prior cesarean section are at risk as well. Women who have had an operation on the uterus such as a D&C or a myomectomy are also potentially at risk, but less so than women with multiple cesarean sections.
What's the risk?
Chances of severe bleeding, which can turn fatal, are high among those who have placenta accreta, but especially when the problem is not known prior to delivery. Complications also include damage to the bladder and multiple medical complications associated with major blood loss.
What are the symptoms?
There are typically no symptoms of placenta accreta, but painless vaginal bleeding may often be seen with placenta previa. Uterine rupture can occur with placenta accreta which results in severe abdominal pain. If not diagnosed by an ultrasound during the pregnancy, delivery can be complicated by heavy bleeding due to the difficulty of detaching the placenta from the uterine wall. Therefore the need for prenatal diagnosis to prepare and plan accordingly is extremely important.
Banner – University Medical Center Phoenix Expertise
With a commitment to excellence in the care of patients with placenta accreta, Banner – University Medical Center Phoenix has developed a multidisciplinary approach utilizing a team of highly skilled specialists. Our comprehensive care management program addresses patient and family needs throughout the pregnancy, at the time of delivery, and postpartum.
An individualized plan of care is created for each mom-to-be by a team of experts in Maternal-Fetal Medicine, Trauma Surgery, Gynecological Oncology, Anesthesia, Interventional Radiology, Urology, Neonatology, as well as nursing, clinical specialization, social work and case management, among others. Additionally, the hospital's laboratory and blood bank are also readily mobilized so that the patient benefits from having a coordinated approach to care.
Our experienced doctors and nurses are prepared to care for these highly complex pregnancies and deliveries, and for any emergencies that may arise. Patients have the knowledge and peace of mind that Banner – University Medical Center Phoenix has the resources to promptly assemble highly skilled specialists from multiple disciplines should the need arise.
Since implementing this comprehensive care approach in 2012 at Banner – University Medical Center Phoenix, placenta accreta patients have had shorter hospital stays, and needed fewer ICU admissions.
For more information about the Placenta Accreta Program, please call our Maternal Fetal Center at (602) 839-2248.