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Placenta
Accreta
The placenta normally attaches
to the uterine wall, however there is a condition that occurs where the
placenta attaches itself too deeply into the wall of the
uterus. This
condition is known as placenta accreta, placenta increta, or
placenta percreta depending on the severity and deepness of the placenta
attachment. Approximately 1 in 2,500 pregnancies experience placenta
accreta, increta or percreta.
What is the difference between accreta, increta or percreta
?
The difference between placenta accreta, increta or percreta is determined
by the severity of the attachment of the placenta to the uterine wall.
Placenta Accreta occurs when the placenta attaches too deep in the uterine
wall but it does not penetrate the uterine muscle. Placenta accreta is the
most common accounting for approximately 75% of all cases.
Placenta Increta occurs when the placenta attaches even deeper into the
uterine wall and does penetrate into the uterine muscle. Placenta increta
accounts for approximately 15% of all cases.
Placenta Percreta occurs when the placenta penetrates through the entire
uterine wall and attaches to another organ such as the bladder. Placenta
percreta is the least common of the three conditions accounting for
approximately 5% of all cases.
What causes placenta accreta ?
The specific cause of placenta accreta is unknown, but it can be related
to placenta previa and previous cesarean deliveries. Placenta accreta is
present in 5% to 10% of women with placenta previa.
A cesarean delivery increases the possibility of a future placenta accreta,
and the more cesareans, the greater the increase. Multiple cesareans were
present in over 60% of placenta accreta cases.
What are the risks of placenta accreta to the baby ?
Premature delivery and subsequent complications are the primary concerns
for the baby. Bleeding during the third trimester may be a warning sign
that placenta accreta exists, and when placenta accreta occurs it commonly
results in a premature delivery. Your healthcare provider will examine
your condition and use medication,
bed rest and whatever else necessary to
help continue the pregnancy towards full term.
What are the risks of placenta accreta to the mother ?
The placenta usually has difficulty separating from the uterine wall. The
primary concern for the mother is hemorrhaging during manual attempts to
detach the placenta. Severe hemorrhaging can be life threatening. Other
concerns involve damage to the uterus or other organs (percreta) during
removal of the placenta. Hysterectomy is a common therapeutic
intervention, but the results involve the loss of the uterus and the
ability to conceive.
What is the treatment for placenta accreta ?
There is nothing a woman can do to prevent placenta accreta, and there is
little that can be done for treatment once placenta accreta has been
diagnosed. If you have been diagnosed with placenta accreta your
healthcare provider will monitor your pregnancy with the intent of
scheduling a delivery and using a surgery that may spare the
uterus. It is
particularly important to discuss this surgery with your doctor if you
desire to have additional children.
Unfortunately, placenta accreta may be severe enough that a hysterectomy
may be needed. Again, it is important to discuss surgical options with
your healthcare provider.
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