What is Placenta accreta ? Know what the Medical research says!

Pregnancy is a remarkable journey, but it can come with its share of complications. One such condition that has gained increasing attention in recent years is placenta accreta. In this article, we will delve into the intricacies of placenta accreta, its types, symptoms, causes, and treatments. We will also explore the latest medical research on this condition and its future implications.

What is placenta acreata? 

Placenta accreta is a medical condition that occurs during pregnancy. It is characterized by the abnormal attachment of the placenta to the uterine wall. In a normal pregnancy, the placenta attaches to the uterine wall, and it is designed to detach easily after childbirth. However, in cases of placenta accreta, the placenta attaches too deeply and firmly to the uterine wall; which makes it difficult to separate.

Placenta accreta is a serious and potentially life-threatening condition because it can lead to severe bleeding during delivery. The severity of placenta accreta can vary. There are different types, including accreta, increta, and percreta, which depends on how deeply the placenta is embedded.

How it it dangerous for the pregnant women? 

Placenta accreta poses significant dangers to pregnant women due to its potential to cause life-threatening complications. The primary danger lies in the risk of severe hemorrhage (excessive bleeding) during childbirth. Other risk factors are discussed below: 

1. Excessive Bleeding: Placenta accreta can lead to severe hemorrhaging during childbirth.
2. Life-Threatening Emergency: The uncontrollable bleeding can quickly become a life-threatening emergency, necessitating immediate medical intervention.
3. Surgical Procedures: Women with placenta accreta often require emergency surgery, blood transfusions, and, in severe cases, a hysterectomy.
4. Long-Term Complications: Placenta accreta can result in long-term complications, including future fertility challenges and emotional distress.
5. Impact on Emotional Well-Being: Coping with the diagnosis and treatment of placenta accreta can be emotionally and psychologically distressing.
6. Importance of Early Detection: Early detection through prenatal care and imaging is crucial to managing the condition and minimizing the associated risks.

What are the symptoms of Placenta acreaata? 

Placenta accreta may not always present noticeable symptoms before delivery, and it is often diagnosed through imaging studies or during childbirth. However, in some cases, women with placenta accreta may experience the following symptoms:

1. Abnormal Bleeding: Unusual vaginal bleeding, especially in the third trimester, can be a sign of placenta accreta. This bleeding may be painless and may not resemble typical menstrual bleeding.
2. Pelvic Pain: Some women with placenta accreta may experience mild to severe pelvic pain or discomfort. This pain can be persistent or intermittent.
3. Decreased Fetal Movements: Reduced fetal movements or changes in the baby’s activity patterns could be a sign of placenta accreta. This is because the placental abnormalities can affect fetal oxygen and nutrient supply.
4. Preterm Contractions: Placenta accreta can sometimes cause premature contractions, leading to preterm labor.
5. Palpable Mass: In rare cases, a healthcare provider may be able to feel a firm, irregular mass during a physical examination.

It’s essential to note that these symptoms are not exclusive to placenta accreta and can overlap with other pregnancy complications. If any of these signs or symptoms are experienced during pregnancy, it is crucial to seek immediate medical attention. Early detection and medical intervention can significantly improve outcomes for both the mother and the baby.

What causes placenta accreta?

Placenta accreta is a complex condition, and its precise cause is not fully understood. However, several factors and risk factors have been identified that may contribute to the development of placenta accreta. These include:

1. Previous C-Section or Uterine Surgeries: Women who have had previous cesarean sections (C-sections) or other uterine surgeries. This is because scar tissue from these surgeries can disrupt the normal attachment of the placenta to the uterine wall.

2. Advanced Maternal Age: Women over the age of 35 have a higher risk of placenta accreta. The exact reason for this association is not clear but may be related to changes in the uterine environment with age.

3. Placental Abnormalities: Certain placental abnormalities, such as a low-lying placenta (placenta previa) or a large placenta (placenta previa), can increase the risk of placenta accreta.

4. Multiple Pregnancies: Women carrying multiple fetuses (twins, triplets, etc.) have a higher risk of placenta accreta due to the increased demands on the placenta.

5. Uterine Abnormalities: Anomalies or irregularities in the shape or structure of the uterus can predispose a woman to placenta accreta.

6. In Vitro Fertilization (IVF): Some studies suggest that pregnancies conceived through IVF may have a slightly increased risk of placenta accreta, although the overall risk remains low.

7. Smoking and Cocaine Use: Certain lifestyle factors, such as smoking and cocaine use during pregnancy.

It’s important to note that while these factors increase the likelihood of developing placenta accreta, the condition can still occur without any identifiable risk factors.

What are the three types of placenta accreta?

Placenta accreta is a condition that encompasses three main types, rather than just two. These types are:

1. Placenta Accreta: In this type, the placenta attaches too firmly to the uterine wall, specifically the myometrium (the muscular layer of the uterus). It is the mildest form of the condition but can still lead to complications during childbirth.

2. Placenta Increta: Placenta increta occurs when the placenta’s attachment goes deeper into the myometrium, penetrating further into the uterine muscle. This makes separation of the placenta after delivery more difficult and increases the risk of bleeding.

3. Placenta Percreta: Placenta percreta is the most severe form of placenta accreta. In this type, the placenta not only attaches to the myometrium but also breaches the uterine wall and may even invade nearby organs such as the bladder. Placenta percreta is associated with the highest risk of severe bleeding and complications during childbirth.

The severity of the condition depends on how deeply the placenta is embedded into the uterine wall, with placenta percreta being the most dangerous and challenging to manage. The distinction between these types is crucial for planning the appropriate medical care and interventions during pregnancy and childbirth, as each type requires a different approach to ensure the safety of both the mother and the baby.

What are the treatments of Placenta acreata? 

The treatment of placenta accreta typically involves careful planning and coordination between medical professionals to ensure the safety of both the mother and the baby. The specific treatment approach can vary depending on the severity of the condition, the gestational age of the fetus, and the overall health of the mother. Here are some common treatment options for placenta accreta:

1. Scheduled C-Section: In most cases of placenta accreta, a planned C-section (cesarean section) is the preferred method of delivery.

2. Preoperative Planning: Prior to the C-section, a detailed preoperative plan is developed. This may include identifying the location of blood vessels near the placenta and having a team of experienced surgeons, anesthesiologists, and nurses on standby.

3. Blood Transfusions: Given the high risk of bleeding, arrangements for blood transfusions are often made in advance.

4. Hysterectomy: In some severe cases of placenta accreta, a hysterectomy (removal of the uterus) may be necessary to control bleeding and prevent further complications. This step is typically considered when other measures are insufficient to control bleeding.

5. Postoperative Care: Following delivery, close monitoring and postoperative care are essential. The medical team will watch for any signs of bleeding, infection, or other complications.

6. Neonatal Care: Depending on the gestational age at delivery, neonatal care may be required for the baby, especially if the delivery is preterm. Neonatal intensive care unit (NICU) support may be necessary.

It’s important to note that early detection of placenta accreta through prenatal care and imaging is crucial to develop an appropriate treatment strategy and to minimize the risks associated with this condition. The goal is always to ensure the best possible outcome for both the mother and the baby.

Placenta accreta vs percreta

Placenta accreta and placenta percreta are two related but distinct conditions that involve abnormal placental attachment to the uterine wall during pregnancy. Here’s a comparison of the two:

What the medical research say about Placenta acreata and what is the future? 

Medical research on placenta accreta is advancing, focusing on early detection, innovative treatment strategies, and risk factors. Early detection through advanced prenatal screening methods like ultrasound and MRI is improving planning and management. Multidisciplinary approaches involving specialists aim to optimize patient care. Research into risk factors enhances risk assessments and interventions. Studies are exploring fertility preservation options for women who require hysterectomies due to severe placenta accreta. Patient education and awareness campaigns empower individuals and healthcare providers. Continued research holds promise for safer pregnancies and improved outcomes in the future.

Conclusion 

In conclusion, placenta accreta is a complex condition with potentially serious risks during pregnancy and childbirth. However, ongoing medical research offers hope for early detection, improved treatment, and better outcomes. By raising awareness and collaborating across specialties, we can look forward to a future. This will ensure safer pregnancies for women around the world.

 Frequently asked questions

1. What is the primary danger of placenta accreta?

 Excessive bleeding and the need for emergency C-sections are the primary dangers associated with placenta accreta.

2. Can placenta accreta be prevented?

While it cannot always be prevented, early diagnosis and proper prenatal care can improve outcomes.

3. How common is placenta accreta? 

 Placenta accreta is relatively rare, occurring in about 1 in 2,500 pregnancies in the United States.

4. Is placenta accreta hereditary? 

There is no direct evidence to suggest that placenta accreta is hereditary, but a history of uterine surgeries may increase the risk.

5. What are the long-term implications for mothers with placenta accreta? 

Long-term implications can vary, but they may include future fertility challenges and the need for careful planning in subsequent pregnancies.