Placenta Accreta

Placenta Accreta
The placenta is an organ that develops in the uterus during pregnancy to provide oxygen and
nutrients to your baby and to remove waste products from the baby’s blood. Normally, the
placenta attaches to the wall of the uterus during pregnancy and is delivered after you have
your baby. However, 1 in 500 women develop a condition called abnormal adherent placenta,
which means that the placenta has grown deeper than it should, into the lining or wall of the
uterus, and can’t detach after childbirth.
There are three types of abnormal adherent placenta, determined by how deep the placenta
has grown:
 Placenta accreta—the placenta grows into the lining of the uterus. This is the most
common type, occurring in 75% of cases.
 Placenta increta—the placenta grows into the wall of the uterus.
 Placenta percreta—the placenta grows through the wall of the uterus, at times into
nearby organs such as the bladder or colon.
This condition can be very serious and may lead to hemorrhaging, organ failure, acute
respiratory distress syndrome, and even death. Providers at University of Utah Health are
specifically trained to care for patients with placenta accreta, and, to date, have a zero percent
mortality rate for this condition.
RISK FACTORS
If you have had a cesarean delivery (C-section) before, you have a higher risk of developing
placenta accreta. This risk increases with each additional C-section you have, especially if you
also have a history of placenta previa (when the placenta covers the opening in the mother’s
cervix).
You may also have a higher risk if you:

 are 35 or older,
 have had multiple past pregnancies,
 have had surgery on or around your uterus, or
 have Asherman’s syndrome.
SYMPTOMS AND DIAGNOSIS

Typically, women with placenta accreta do not have any signs or symptoms, although you might
notice abnormal bleeding during the third trimester. If you have had multiple C-sections or
surgery to or around your uterus, you should seek care as early as possible to ensure the safety
of you and your baby.
Your doctor will perform an ultrasound from the outside (over the belly) and from the inside (in
the vagina) to best see where the placenta is and if it is growing normally. If the results of the
ultrasound are unclear, your doctor might have you get an MRI in order to better diagnose you.
CARE DURING PREGNANCY AND DELIVERY

If you are diagnosed with placenta accreta, our team of scientists, doctors, research
coordinators, fellows, residents, and nurses will monitor you closely during your pregnancy and
delivery. Your case will be added to a monthly placenta accreta conference, where providers
will discuss your care and determine next steps.
Women with placenta accreta are at risk of going into labor early, which can cause severe
bleeding and is very dangerous if you’re not able to quickly get care from experienced
specialists and surgeons. We recommend planning to have your delivery between 34 and 36
weeks (a month or more before the due date) to avoid labor and bleeding, while still avoiding
most newborn prematurity complications.
Precautions during Pregnancy

Because you will most likely have your baby before your due date, you will be given steroid
shots during your pregnancy to help prepare your baby for the outside world. This can help
decrease the chance of breathing problems and other issues in premature babies.
In the third trimester, you may want to consider moving closer to the hospital if you live more
than 30–40 minutes away, in order to avoid being too far away when labor or bleeding start.
Delivery
On the day of delivery, we will have several teams on standby to ensure everything goes
according to plan, including:
 Blood Bank
 NICU
 Anesthesia
 General Obstetrics
 Maternal Fetal Medicine
 Labor & Delivery
 Support Staff
 Nursing
 Gynecology/Oncology
Vaginal delivery is not possible in most cases, so you’ll likely have a C-section to deliver your
baby. The majority of patients will need to have a total or partial hysterectomy immediately
following delivery, with the placenta left inside the uterus when it is removed to avoid bleeding.
In rare cases it is possible to safely avoid a hysterectomy by removing most of the placenta and
leaving the portion attached to the uterus, but this option can lead to complications in future
pregnancies.
Recovery
Recovery is different for every patient. You’ll most likely stay in the hospital for 3–5 nights after
delivery, similar to recovery after a C-section. Some women will need to stay in the intensive
care unit for a day or two to help them recover from blood loss. You’ll also be given pain
medicine through an IV while in the hospital and oral pain medicine to help manage your pain
after you return home.

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Placenta Accreta

You may also have a higher risk if you:

SYMPTOMS AND DIAGNOSIS

CARE DURING PREGNANCY AND DELIVERY

Precautions during Pregnancy

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