Understanding Placenta Accreta: Causes, Symptoms, and Treatment

Placenta accreta is a rare but serious pregnancy condition where the placenta attaches itself more deeply into the uterine wall than normal. This condition can be life-threatening and requires careful management. There are different types of placenta accreta based on the depth of invasion into the uterine wall:

  1. Accreta: This is the most common type and involves superficial invasion into the muscular layer below the endometrium.
  2. Increta: Increta indicates deeper invasion into the uterine muscle.
  3. Percreta: This is the most serious type and involves the invasion through the uterine musculature, potentially extending into nearby pelvic organs, such as the bladder.

Placenta accreta affects approximately 1 in 533 pregnancies, and its prevalence has been rising due to the increased number of Cesarean deliveries performed in recent decades. The primary risk factor for placenta accreta is a prior C-section, and other risk factors include prior uterine surgery, maternal age over 35, prior postpartum endometritis, fertility treatments, and placenta previa (when the placenta covers the cervix).

Symptoms of placenta accreta are usually not apparent until delivery. The condition can lead to severe hemorrhage and other complications, making early detection through ultrasound critical.

Complications of placenta accreta can include preterm delivery, excessive bleeding, and the need for a hysterectomy to control bleeding and save the mother’s life.

Placenta accreta is typically diagnosed in the second or third trimester through patient history and diagnostic imaging, such as ultrasound or MRI. Early diagnosis is essential to ensure the best outcomes for both the mother and baby.

The treatment of placenta accreta involves careful monitoring throughout pregnancy. A scheduled C-section is usually performed between 34-36 weeks unless complications arise earlier. In some cases, a hysterectomy may be necessary at the same time as the C-section. Other procedures, such as partial cystectomy, may be required if the placenta has grown into other structures outside the uterus. Treatment options vary depending on the patient’s specific situation, and the goal is to minimize complications and ensure the well-being of both the mother and baby.

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