Placenta Accreta: Steps to Avoid Dangerous Complications during Pregnancy

Placenta accreta is a rare but potentially dangerous condition that has become more prevalent due to the increasing rates of cesarean section and elective surgeries. This article aims to shed light on the significance of placenta accreta, its causes, associated risks, treatment options, and preventive measures that pregnant women can take to safeguard themselves and their babies.

Understanding Placenta Accreta: Placenta accreta is a pathological condition where the placenta fails to detach from the uterine wall after childbirth. Instead, it adheres to the uterine muscle, and in severe cases, it may even invade nearby organs. 

When the placenta is deeply attached, it cannot separate from the uterus or only partially detaches, resulting in persistent bleeding. This can lead to complications such as the need for blood transfusion, postoperative infections, and fistulas.

Causes and Risk Factors: Placenta previa, a condition where the placenta develops in the lower part of the uterus, is closely associated with placenta accreta. Pregnant women with a history of placenta previa and previous uterine surgery or cesarean section are at higher risk. 

The likelihood of placenta accreta increases with the number of previous cesarean sections, and the rates can reach up to 25% for women who have had a cesarean section. Additional risk factors include a history of abortion, advanced maternal age (35 years or older), smoking habits, uterine fibroids, and Asherman syndrome, which causes scarring of the uterus.

The Potential Dangers of Placenta Accreta: Placenta accreta poses several risks, including:

• Postpartum hemorrhage requiring blood transfusion, jeopardizing the mother's life.

• Postpartum infections.

• Premature birth due to excessive bleeding.

• Hysterectomy, the removal of the uterus, in severe cases.

• In situations where the placenta invades the bladder or rectum, partial removal of these organs may be necessary to control the bleeding.

Mild cases may be managed with resuscitation and measures to stop uterine bleeding. In severe cases, the uterus may need to be removed, especially if the placenta has invaded the bladder or rectum. Skilled surgeons employ techniques to minimize blood loss and preserve fertility in subsequent pregnancies.

Managing Placenta Accreta: When placenta accreta is diagnosed before birth, treatment options are based on the extent of adhesion and adjacent organ damage. In cases of deep placental attachment and invasion, the recommended approach is a cesarean section, leaving the placenta intact and removing the uterus along with the placenta. This minimizes blood loss and reduces the risk of damage to surrounding organs. 

For less severe cases, a cesarean section can be performed, followed by the removal of accessible parts of the placenta. Medications may be used to facilitate the elimination of remaining placental tissue. Prompt identification of placenta accreta after childbirth enables timely intervention, depending on the mode of delivery (cesarean or vaginal) and the extent of blood loss.

Reducing the Risk of Placenta Accreta: Pregnant women can take certain measures to reduce the risk of developing placenta accreta:

• Avoid multiple abortions or surgeries on the uterus, as these can increase the likelihood of placental abnormalities.

• Seek early and regular prenatal care to monitor the health of the placenta and identify any potential complications.

• Follow the guidance of healthcare professionals and obstetricians who specialize in high-risk pregnancies. They can provide valuable insights and recommend appropriate interventions.

• Maintain open and honest communication with your healthcare team. Inform them about your medical history, previous cesarean sections, or any other relevant factors that may increase the risk of placenta accreta.

• Educate yourself about the signs and symptoms of placenta accreta, such as persistent bleeding after delivery or failure of the placenta to detach naturally. If you notice any concerning symptoms, promptly report them to your healthcare provider for further evaluation.

• Stay calm and trust the expertise of your healthcare team. Placenta accreta can be a challenging condition to manage, but with timely diagnosis and appropriate treatment, the risks can be minimized for both mother and baby.

By staying informed, seeking regular prenatal care, and collaborating closely with healthcare professionals, women can significantly reduce the risks associated with placenta accreta. Remember, early diagnosis and timely intervention are crucial in ensuring the well-being of both mother and baby.