Doctor insights on:
Does Placenta Accreta Cause Hypovolemic Shock
Uterine scars/defect: The placenta tends to implant over pre-existing uterine scars or defects; when that occurs, the invasive nature of the placenta can lead to abnormally increased vascularity in areas without sufficient uterine muscle to control the bleeding once the placenta is delivered (particularly near the cervix). That is potentially life-threatening if undiagnosed until delivery and managed in small hospital! ...Read moreSee 1 more doctor answer
Shock is a condition in which a person cannot circulate enough blood (carrying oxygen & nutrients) to the vital organs in the body. If shock persists, various parts of the body will stop working, and the person will die. Causes of shock include injuries, excessive bleeding, heart failure, infections, chemical imbalances, ...Read more
Different things: These are distinctly different things. A subchorionic hematoma is a collection of blood in the layer between the membranes and the placenta. It is typically found in the 1st trimester when someone experiences bleeding. A placenta accreta is when the placenta is attached too deeply into the uterine wall. You could have both things but they are not typically related. ...Read more
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?
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. ...Read more
Very definitely: Unfortunately, placenta accreta is often diagnosed at the time post delivery when a cotyledon(plug) of placenta is missing or the placenta itself does not detach normally. At that point, aggressive measures to 'detach" the placenta may result in massive hemorrhage and the resultant post apocalyptic diagnosis of placenta accreta. ...Read more
Yes - prematurity,: Placenta previa/accreta typically leads to preterm contractions and rupture of membranes requiring delivery before 37 weeks. Thus, the minor risk is for mild prematurity for the fetus/neonate. The main risk is maternal and can prove lethal if the diagnosis is not prenatally suspected and appropriate expert care is not sought in a timely fashion. ...Read moreSee 1 more doctor answer
Massive, brief.: Profuse, life-threatening bleeding occurs suddenly if the placenta is allowed or forced to separate from the uterus in cases of accretism. Unless this is promptly and expertly treated with hysterectomy, maternal death from exsanguination occurs soon. Accreta bleeding is not chronic. Delivery at tertiary hospital/trauma center with large blood bank and mfm gyn oncologist surgical care is needed! ...Read more
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. ...Read more
Ultrasound, Doppler.: The provisional working diagnosis is achieved prenatally with history taking and a targeted ultrasound examination by an expert in the field. Mri is not generally helpful, unless the placental invasion is posteriorly. The final diagnosis is made by pathological examination of the uterus and placenta en bloc after a cesarean hysterectomy. ...Read moreSee 1 more doctor 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. ...Read moreSee 1 more doctor answer
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