Placenta accreta, at delivery

Definition

What is placenta accreta?

The placenta (placenta) usually attaches to the uterine wall during pregnancy and will release spontaneously after delivery.

However, in certain cases, the placenta can stick too deep into the uterine wall so that it does not come off.

A placenta that does not detach during delivery can put a pregnant woman at risk for severe vaginal bleeding which can sometimes be fatal.

The complication of this pregnancy is placenta accreta.

Placenta accreta or placenta accreta is a condition that is included in the group "retained placenta" aka retained placenta.

Placenta accreta is a condition in which the placenta does not escape from the uterus within one hour of the birth of the baby.

The placenta is not only attached to the uterine wall, but placental tissue can actually grow deeper into the uterine wall.

Sticky placenta or placenta is one of several complications of childbirth.

If you are found to have placenta accreta in your current pregnancy, your doctor will usually choose a caesarean section over a normal delivery later, according to the Mayo Clinic.

So, make sure you immediately see a doctor if you feel the signs of childbirth have started to appear.

Various signs of labor will begin which include the presence of original labor contractions, rupture of the amniotic fluid, opening of delivery, and others.

In order not to get confused, make sure you can distinguish between real and false contractions.

If you are accompanied by a doula from pregnancy, the doula can help you identify the real symptoms of labor.

Cause

What causes placenta accreta?

It is not known exactly what causes placenta accreta or placenta stickiness.

The cause of placenta accreta or sticky placenta occurs due to the presence of scar tissue after cesarean section or other surgery on the uterus.

In fact, placenta previa can also be a cause of placenta accreta or placenta stickiness.

According to the American Pregnancy Association, placental adhesions or this can be experienced by about 5-10% of women with placenta previa.

Delivery by caesarean section is considered to increase the likelihood of the mother experiencing placental adhesions in the next labor.

The more cesarean sections the mother undergoes each time she gives birth, the greater the chance for the mother to experience placental adhesions.

However, in some cases, the cause of sticky placenta can also occur without a previous history of surgery on the uterus.

Signs and symptoms

What are the signs and symptoms of placenta accreta?

Women with placenta accreta usually do not show any signs or symptoms during pregnancy.

However, in some cases, this condition causes vaginal bleeding during the third trimester of pregnancy.

Call your doctor right away if you experience vaginal bleeding during the third trimester of pregnancy.

If you experience heavy bleeding, such as bleeding in less than 45 minutes, heavy, and accompanied by stomach pain, see your doctor immediately.

The option of having a hospital delivery is preferable to the mother if she has symptoms related to any complications during pregnancy that are at risk of occurring during delivery.

Meanwhile, if you give birth at home, the treatment that the mother will receive later may be less than optimal, such as during labor in the hospital.

Do not forget, prepare various childbirth preparations along with the delivery equipment needed by mothers, fathers, and babies when the day of birth arrives.

Risk Factors

Who is at risk for placenta accreta?

Having a history of cesarean delivery or uterine surgery (eg removal of uterine fibroids) is known to increase the risk of placenta accreta for future pregnancies.

The more cesarean births a woman has, the greater the risk.

Several other factors are also thought to increase the risk of developing placenta accreta or placenta accreta, including the following:

Placenta previa, a condition that causes the mother's placenta to cover part or all of the cervix (cervix). Placenta adhesions are diagnosed in 5-10 percent of pregnant women who have placenta previa
The placenta is located at the bottom of the uterus.
Pregnant women over 35 years of age.
The mother has uterine abnormalities, such as scar tissue or uterine fibroids.

Placenta accreta or placenta accreta is a condition that can occur in women without a history of uterine surgery or placenta previa.

Diagnosis

How do doctors diagnose this condition?

Sometimes this condition is discovered by doctors during childbirth. But in most cases, women are diagnosed while pregnant.

Doctors usually run several tests to make sure the placenta has not grown to the uterine wall if the mother has several risk factors for placental adhesions.

Some common tests to check for this condition include imaging tests, such as ultrasound, magnetic resonance imaging (MRI), and blood tests.

If placenta accreta is diagnosed and treated properly, women usually experience a full recovery without lasting complications.

Treatment

How is placenta accreta treated?

When the doctor has diagnosed you with this placental attachment condition, usually the doctor will make a plan to ensure that the baby can be born safely.

Severe cases of placenta accreta are generally treated with surgery.

First, the doctor will perform a caesarean section as a way of delivering the baby.

During the delivery process by caesarean section, the mother may continue to have blood transfusions even after delivery.

If the bleeding continues until after delivery, the mother needs to get intensive care to restore her body condition.

Apart from surgery as a treatment for placenta accreta, another option is to remove your uterus (hysterectomy).

This is to prevent serious blood loss that can occur if part or all of the placenta that is attached to the uterus is left behind after the baby is born.

However, once the uterus is removed, you no longer have a chance of getting pregnant again in the future.

If you plan to get pregnant again at a later date, it's best to discuss treatment options with your doctor.

Your doctor can help you consider the most appropriate treatment options and according to your body's conditions and needs.

Complications

What are the complications of placenta accreta?

Bleeding during the third trimester may be a warning sign of placenta accreta.

If this happens, it will usually be followed up with preterm labor, especially when the mother is experiencing heavy bleeding.

Preterm labor and subsequent placenta accreta complications are major problems for infants.

Risks to the baby during cesarean delivery are rare and include surgical injury or breathing problems.

A placenta that won't escape from the uterus is considered a potentially life-threatening complication of childbirth.

A woman with placenta accreta may experience severe vaginal bleeding that makes her lose an average of 3-5 liters of blood during childbirth.

In comparison, the average adult has about 4.5-5.5 liters of blood in their body.

This automatically makes many mothers who experience placental attachment inevitably need to undergo blood transfusions during childbirth due to this bleeding.

In fact, the placenta can be left intact and attached to the body so that over time the tissue will dissolve on its own.

Unfortunately, it can lead to serious complications, which may include a severe uterine infection.

Severe infections of the uterus can usually be treated by removing the uterus.