Women's Services
 

 Placenta Accreta

Placenta IllustrationWhat is Placenta Accreta?

The placenta normally attaches to the wall of the uterus. Rarely, the placenta attaches incorrectly - it is then called a placenta accreta, increta, or percreta, depending on how deep the placenta attaches to theuterus. Then, after delivery of the baby, the placenta won’t separate from the uterus, which can lead to serious problems. This problem occurs in about one in 2,500 deliveries.

Diagnosis of Placenta Accreta

  • Ultrasound examination (abdominal, vaginal, and color Doppler imaging)
  • MRI (magnetic resonance imaging) to confirm ultrasound examination findings

Risk Factors

  • Placenta previa, when the placenta covers the cervix (opening to the uterus) blocking the birth canal
  • Prior cesarean delivery or other uterine surgery
  • Advanced maternal age (more than 35 years of age)
  • Prior curettage of the uterus (D&C)
  • Grand multiparity (five or more children delivered in separate pregnancies)

Plan for Delivery

  • Admission to hospital the evening before cesarean delivery (if not already in the hospital)
  • In early morning (in Labor & Delivery):
    • Placement of intravenous catheter
    • Apply fetal monitor
    • Place epidural for anesthesia
  • In Interventional Radiology (IR):
    • Placement of a two balloon catheter through the groin to prevent hemorrhage (excessive bleeding)
  • Transfer to operating room for delivery
  • Transfer to Surgical Intensive Care Unit (SICU) for recovery following surgery for about 24 hours
  • The father of the baby or significant other may accompany you to the OR for the delivery of the baby. This person will go with the baby to the Infant Special Care Unit.
  • After the surgery, your family can visit you in the SICU
  • Breastfeeding is encouraged as soon as possible
  • In time, you will be transferred to the Family Maternity Care Center
  • Prior to discharge, a follow-up appointment at the High Risk OB Clinic will be scheduled

The best outcome for mother and baby is a planned delivery. However, if you start bleeding or have signs of labor at anytime, it is important to get to the hospital right away.

Potential Problems

  • Excessive bleeding (hemorrhage)
  • Need for multiple blood transfusions
  • Damage to other organs during surgery, especially the bladder
  • Abnormal blood clotting

Read more information: Understanding Placentra Accreta brochure (PDF)