Doctor insights on:
Medicine For Placenta Accreta
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
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
Placenta accreta: A placenta accreta develops when the placenta invades or grows into the muscular layer of the uterus. With invasion of the muscle, detachment of the placenta after birth of the infant cannot occur. Retention of the placenta can lead to a postpartum hemorrhage. To remove the placenta, the uterus is usually removed after delivery of the infant. ...Read moreSee 1 more doctor 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. ...Read moreSee 2 more doctor answers
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
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
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
Can you detect placenta accreta on an 18 obstetrical week ultrasound? My midwife says you can't see pa, but it was my understanding that you could.
You certainly can!: Expert eyes can discern the tell-tale signs of placenta accreta as early as the first trimester - in fact recent evidence suggests that is the best time to detect this potentially life-threatening complication of pregnancy. It is certainly possible to diagnose accreta at 18 weeks - I have done it repeatedly and confirmed it at delivery. ...Read moreSee 1 more doctor answer
Why am i still hurting after having a baby 9 months ago? I was diagnosed with placenta accreta after the birth of my child my doctor didn't do surgery to remove it he just pulled it out was he suppose to do that?
Confused..: Your information is a little confusing to me; are you concerned about long-term pain from your delivery, or asking whether the management of placenta accreta was appropriate in your case? Please clarify. Any time pain persists that far out after delivery it is abnormal and merits examination by a gynecologist. Standard management of suspected placenta accreta is prelabor cesarean hysterectomy @35w. ...Read moreSee 1 more doctor answer
Anterior placenta previa with placental lake seen at 28w ultrasound, 2 D&Cs & no c-section hx. Any risk of placenta accreta? Best time to deliver?
Placenta Previa: Placenta previa occurs when the placenta is covering the opening of the cervix. Vaginal delivery is possible in mild cases of previa. Placenta accreta is a different condition where the placenta gets "stuck" to the uterus. While the risk of accreta increases when you have previa, that risk is low if you have never had a c-section before. Follow-up with your obstetrician regarding delivery dates. ...Read more
Cesarean hysterectom: Planned prelabor repeat cesarean section by 34-35 weeks after Betamethasone administration without attempt at placental delivery is the treatment of choice! this should only be undertaken in a tertiary care hospital in concert with maternal-fetal medicine, gynecology-oncology, urology, blood bank, perinatal anesthesia, general surgery and neonatology - to minimize the risk of maternal death. ...Read more
Prelabor c-hyst @34w: The optimal management of placenta previa with suspected accreta/increta/percreta is prelabor cesarean section by 34-35 weeks after Betamethasone administration without amniocentesis for fetal lung maturity; this should be immediately followed by puerperal hysterectomy with the expert help from a gynecologic oncologist, urologist, [vascular] surgeon. Do not attempt to detach the placenta! ...Read moreSee 2 more doctor answers
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