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Placenta Accreta: A complication you should be aware of

 

Placenta accreta is a serious medical complication, which can occur during the final stages of pregnancy. In this condition, the placenta is too deeply attached with the inner muscular linings of the uterine wall. It is a rare condition and needs to be treated under quality medical supervision. Here is all that you need to know about placenta accreta:

What is Placenta?

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Placenta is the organ which connects the growing baby (fetus) to the inner wall of the uterus. It provides nutrients, oxygen and other vital(s) to the fetus. Also, it provides a passage for any disposal of waste material through the mother’s blood vessels. Further, it fights against internal infection and helps with balancing hormones necessary during pregnancy.

During normal delivery, the placenta is attached only to the lining of the uterus. It smoothly separates from the uterus and is expelled from the body. Placental expulsion can be managed either ‘actively’ or ‘expectantly’.

- actively requires medical guidance under which the placenta is removed within thirty to forty minutes of delivery (via the birth canal)

- expectantly does not require medical attention

Grades of Placenta Accreta

When the placenta is attached to the inner layers of the uterus, it creates complications. Based on the extent of the penetration into the uterus, it is defined into three grades.

- Mild accreta. The placenta is attached deep in the uterine wall, but does not penetrate the muscles

- Increta (moderate accreta). The placenta covers the cervix and penetrates into the uterine wall

- Percreta (extreme accreta). The placenta grows all the way through the wall of the uterus. In other words, there is no separation between placenta and the bladder

Risks for Mother and Child

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Placenta accreta can give rise to several complications for the mother. It can cause heavy vaginal bleeding and hemorrhage (during attempts of removing the placenta). Excessive blood loss can prevent blood from clotting and lead to lung or kidney failure. Severe hemorrhage can also be life-threatening in extreme cases. There is a possibility of damage to the uterus and other organs during the removal of placenta.

For the child, it can lead to premature delivery and even miscarriage sometimes. There may be birth defects and improper growth of the baby in the uterus.

What can potentially lead to Placenta Accreta?

The exact reason for placenta accreta is unknown. However, it is closely related to cesarean section births. Higher the number of C-sections during pregnancy, higher the chances of placenta accreta.

Other causes include multiple children, previous surgery of the uterus, giving birth to duplet or triplets. It is found more commonly in older (35 or more) women and those who smoke regularly.

How can Placenta Accreta be detected?

Placenta accreta usually does not exhibit extreme symptoms. Therefore, it is difficult to detect normally.

However, bleeding during the third trimester of pregnancy is a common indicator. The condition is effectively identified using the following techniques.

- Ultrasound or magnetic resonance imaging (MRI) scans of the uterus

- Blood tests can detect the rise of a protein which is produced by the baby in the mother’s blood. This rise can lead to placenta accreta

What is the treatment for Placenta Accreta?

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The doctor may recommend C-section hysterectomy (surgically removing the uterus). The procedure is also called cesarean hysterectomy. Here, a cut is made in the lower abdomen of the mother and the uterus is opened to deliver the child. The main aim is to prevent life-threatening blood loss and save the organs in the pelvic region.

A few other procedures are available if you feel you want to opt out of a hysterectomy. Doctors may also recommend voluntarily delivering the baby before 38 to 39 weeks to save the mother from further complications.

Placenta accreta is a rare condition with very few women aware of the situation. Most are deeply shocked by such a news since they were never aware such a complication. Famous American reality television personality Kim Kardashian was diagnosed with placenta accreta. When she got the news, she publicly shared her feelings about the problem:

“My doctor had to stick his entire arm in me and detach the placenta with his hand, scraping it away from my uterus with his fingernails. How disgusting and painful! My mom was crying; My delivery was fairly easy, but then going through that—it was the most painful experience of my life!”

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Kim was lucky to have a doctor who had experience with placenta arrieta. Yet, the reality is not all healthcare facilities and doctors are trained to effectively treat this condition. Therefore, make sure the delivery occurs at a specialized center where the staff is well trained and has experience with accreta deliveries - having a multidisciplinary team of specialists.

Happy and safe pregnancy! 

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