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Placenta accreta

Maternal pregnancy complications


Description

Placenta accreta is a condition where part or all of the placenta remains firmly attached to the uterine wall after childbirth. There are two other forms of abnormalities where the placenta attaches even deeper: placenta increta and placenta percreta.

The incidence of placenta accreta is 1 in 2,500 pregnancies and makes up 80% of the cases of placental retention.


Causes

Here are the main causes of placenta accreta:

  • Placenta previa (covering the cervix)
  • History of cesarean section or uterine surgery
  • History of curettage (scraping or removal of tissue lining the uterine cavity)
  • Several pregnancies (6 and over)
  • Advanced maternal age (over 35 years)

Symptoms

It is often the case that women who have placenta accreta have no symptoms during pregnancy. However, vaginal bleeding may occur during the third trimester.

If bleeding occurs, it is important to go immediately to the birth unit so that a doctor can assess the situation.


Tests and procedures

The best way to detect and diagnose placenta accreta is usually through an ultrasound followed by an MRI to confirm the diagnosis.

Hospitalization for bed rest and close supervision is recommended in the case of vaginal bleeding.


Treatment and follow-up care

As the placenta cannot detach on its own, a caesarean section is recommended. In most cases, a hysterectomy will be needed. Childbirth is often complicated by severe hemorrhage, and hysterectomy is the treatment of choice to ensure the safety of the mother.

Different blood samples will be taken (blood group, hemoglobin, compatibility test for the possibility of transfusion).

The mother may also need a blood transfusion after the surgery.

In preparation for the delivery, several specialists are called for consultation:

  • The interventional radiologist will explain to the mom-to-be how balloons inserted through the femoral veins help prevent severe hemorrhaging during cesarean section.
  • The anesthesiologist will analyze the situation and explain to the patient the type of anesthesia recommended for caesarean section.
  • A specialist in urology will also participate in care if the bladder is invaded by placenta percreta.

After childbirth, breastfeeding will be possible.


Resources and useful links

Fiche par

Josée Normandeau, inf. clinicienne et Dre Lucie Morin

About this page
Updated on 12/19/2017
Created on 12/19/2017
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