Question 1

what are the symptoms of placenta accreta?

Accepted Answer

Only at delivery: There are no symptoms during the pregnancy.  Accreta presents with a placenta that will not detach after the infant is born.  If the placenta is manually removed or removed under traction there is a great deal of bleeding, which may require surgery and possibly a hysterectomy.  Accretas can sometimes be diagnosed prior to delivery via ultrasound or mri.

Question 2

can placenta accreta have negative effects on my baby?

Accepted Answer

No: The concern is for mother.  After the baby is born, difficulty with separation and removal of the placenta can result in excess bleeding, a hysterectomy, and a risk to future pregnancies.  It should not harm a current pregnancy.

Question 3

how often does placenta accreta go undiagnosed even after a csection delivery?

Accepted Answer

Placenta accreta: A previously undiagnosed placenta accrete may be diagnosed at the time of a cesarean section.  This would occur when the OB is trying to remove the placenta but cannot because it is attached (accreta). On the other hand, if the placenta detaches easily, the uterine cavity is always explored so it would be rare to have an attached placenta left behind but a focal placenta accrete could be missed.

Question 4

what is the definition or description of: placenta accreta?

Accepted Answer

Abnormal: Placenta actually attaches invasively  to the uterine muscle rather than the uterine lining as it should.
May not be able to be separated when the baby is born.

Question 5

can mri help diagnose placenta accreta?

Accepted Answer

Yes: Sometimes it is superior to sonography for this diagnosis.

Question 6

what is the cause of placenta accreta?

Accepted Answer

Don't know: We don't know all the causes, but we know certain folks are at increased risk, such as having multiple c-sections and placenta previa.

Question 7

what are the tests for placenta accreta?

Accepted Answer

Ultrasound & MRI: An accreta is a more dangerous form of placental abnormality and ultrasound isn't very accurate although it can show signs that concern us. Especially if someone has higher risk factors (previous c-section scar, uterine rupture). An MRI is more diagnostic of a placenta accreta and allows us to make vital preparations for delivery such as blood products, qualified surgeons, & embolization therapy.

Question 8

what makes it likely to have placenta accreta?

Accepted Answer

Uterine scarring: Women with a history of fibroid surgery or previous ceasarean whose placenta implants on scar tissue have a small, but present potential for the placenta to dig in too deeply.  It can just happen de novo, too.

Question 9

what is the best way of managing placenta accreta and percreta?

Accepted Answer

Resorption: If placenta percreta/accreta is recognized at the time of delivery and there is no bleeding then allowing the uterus to contract and retained placenta to be excreted or absorbed later on its' own volition is a wise course. However, if there is massive uncontrollable bleeding then cesarean hysterectomy is the "default" choice. Uterine balloon "packing" can be also be tried to arrest bleeding.

Question 10

if someone has a focal placenta accreta can it detach and come out on its own? have you ever heard of this? or would this be unusual?

Accepted Answer

Placenta Accreta: Placenta Accreta usually occurs when the placenta attaches to a scar from a previous cesarean section. If the placenta grows into the scar it is called placenta increta. If it grows through the wall of the uterus it is called placenta percreta.  These are serious problems which can lead to a cesarean hysterectomy. The diagnosis is suspected by ultrasound or MRI. A focal accreta could detach.

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What is the definition or description of: placenta accreta?

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Can mri help diagnose placenta accreta?

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What are the tests for placenta accreta?

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What makes it likely to have placenta accreta?

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If someone has a focal placenta accreta can it detach and come out on its own? have you ever heard of this? or would this be unusual?

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