Placenta Accreta – Diagnosis and Treatment
Diagnosis
Doctors look for placenta accreta, placenta increta, and placenta percreta by checking for certain risk factors, such as placenta previa or a history of uterine surgery.
They use ultrasound or MRI scans to see how deeply the placenta attaches to the uterine wall. Symptoms like painless vaginal bleeding may also lead to further testing.
In some cases, diagnosis is confirmed during delivery when the placenta does not detach properly, which can cause heavy bleeding.
Treatment
Steps Taken Before the Operation
A coordinated medical team supports patients who may have placenta accreta. This team typically includes an obstetrician-gynecologist, a pelvic surgery expert, anesthesiologists, and specialists for newborn care.
Doctors talk with patients about possible risks, such as heavy blood loss (hemorrhage) or the need for a blood transfusion. Severe bleeding can sometimes lead to time in the intensive care unit after birth.
Sometimes, doctors may suggest hospitalization or “pelvic rest” if there is vaginal bleeding near the end of pregnancy.
| Preparation | Purpose |
|---|---|
| Blood transfusion plan | To handle major blood loss |
| Anesthesia evaluation | To keep the patient comfortable and safe |
| Surgical team review | To prepare for possible complications |
| Intensive care readiness | To respond if bleeding becomes life-threatening |
What Happens During the Procedure
Doctors most commonly use a cesarean section to deliver the baby in these cases. After making incisions in the belly and uterus, they often perform a hysterectomy.
This means the uterus, with the placenta still attached, is removed. Removing the uterus in this way helps lower the risk of dangerous bleeding.
Once doctors remove the uterus, future pregnancies are not possible, so it is important to discuss any family plans with the healthcare team beforehand.
In rare cases, doctors may consider keeping the uterus and placenta in place and letting the placenta break down naturally, but this method can cause problems like severe bleeding, infection, or the need for surgery later.
Additional treatments doctors might use include:
- Uterine artery embolization to control blood flow and reduce bleeding.
- Use of methotrexate in very select cases for conservative management.
- Conservative (uterus-sparing) options, which are rare and carry higher risks.
Handling Emotional and Practical Challenges
Dealing with placenta accreta can be stressful. Many people feel uncertain about their delivery, their baby’s health, and what the future may hold. Taking positive steps can help manage these feelings.
Helpful ways to cope include:
- Learning about the condition. Talking with healthcare providers or reading trustworthy sources can help lessen anxiety. Getting facts and hearing from others with similar experiences can make things clearer.
- Preparing for procedures. Asking questions about the planned C-section and possible hysterectomy can help people know what to expect. Understanding the recovery process and discussing pain management can also ease concerns.
- Focusing on self-care. Taking breaks to rest, read, listen to music, or use relaxation methods like deep breathing can reduce stress. Simple activities can promote calm and help with emotional well-being.
| Support Steps | Examples |
|---|---|
| Get informed | Ask questions, read trusted sources, join a group |
| Prepare for surgery | Learn about procedures, recovery, pain control |
| Practice self-care | Take walks, meditate, listen to calming music |
Support from healthcare teams, family, or friends can also make a big difference during this time.
Getting Ready for Your Visit
Steps You Can Take Before Your Visit
Preparing for an appointment can help people with placenta accreta feel more confident and informed. Here are some practical things to do:
- Check about activity limits. Ask if there are any activities you should avoid, and find out which symptoms mean you should call your provider or go to the hospital.
- Bring someone with you. Having a friend or family member come along can help you remember important information and provide support.
- Prepare questions in advance. Write down your concerns or questions so you remember to ask them. Some helpful questions include:
| Suggested Questions for Your Provider |
|---|
| What is causing my bleeding? |
| What type of treatment do I need? |
| What care is needed during pregnancy? |
| What signs should prompt a call or a visit to the hospital? |
| Is vaginal delivery possible with this condition? |
| Will this increase my risk in future pregnancies? |
| Will I need a hysterectomy after delivery? |
- Stay open to asking more. If new questions come up during your visit, ask them.
- Gather your medical information. Bring a list of any past uterine surgeries or pregnancies, and information on how quickly you could get to the hospital if needed.
Questions Your Provider May Ask You
During your appointment, your provider will need detailed information to help make an accurate plan. Be ready to answer questions such as:
- When did you first notice any bleeding?
- Has the bleeding happened just once, or several times?
- How much blood have you seen?
- Are there any other symptoms, like pain or contractions?
- Have you had any previous pregnancies or surgeries on the uterus?
- If there is an emergency, how quickly can you get to the hospital—including any steps needed to arrange transportation or child care?
Tip: It can help to make notes before the appointment about your symptoms, medical history, and how far you live from the hospital.
