Pregnancy is the most beautiful and responsible time in a mother's life. During this time, it is very normal to feel a little scared and curious about what is happening inside your body and about the health of your baby. Today we are going to talk about a special condition that many people have not heard of, but which is very important for every pregnant mother to be aware of. That is Placenta Accreta . Don't worry, we will talk about everything simply and clearly.
First, let's see, what is this placenta?
Simply put, the placenta is the bridge between you and your baby during pregnancy. It is a special tissue that develops inside the uterus. It is through this placenta that the baby receives all the blood, oxygen, and nutrients that your body needs. It is also through this placenta that the baby's waste products are removed.
What usually happens is that after the baby is born, the placenta detaches from the uterine wall on its own. We also call this "placenta delivery."
So, what is this serious condition called Placenta Accreta?
Placenta Accreta is when the placenta attaches too deeply and tightly to the uterine wall, which is not normal. Normally, the placenta attaches only to the thin lining of the uterus (the endometrium). However, in this case, the placenta can attach even deeper, all the way to the uterine muscles .
When it is attached this tightly, the placenta cannot easily come out after the baby is born. When you try to remove it, it can cause heavy bleeding. This is the main and most dangerous problem here.
There are two main types of Placenta Accreta:
This condition is divided into three main types depending on the depth at which the placenta attaches to the uterine wall. Let's understand this with a table.
| Quality type | Description |
|---|---|
| Placenta Accreta | This is the most common and least severe type. Here, the placenta attaches to the uterine wall, but does not damage the uterine muscles. |
| Placenta increta | Here, the placenta has grown not only into the uterine wall, but also into the uterine muscle. |
| Placenta Percreta | This is the most severe and dangerous type. Here, the placenta has penetrated the uterine wall and may have attached itself to nearby organs, such as the bladder or intestines. |
Why does this situation occur?
The number of reports of this condition has increased slightly in the past few decades. The main reason for this has been identified as the increase in the number of cesarean sections (C-sections) .
Imagine that you had a previous baby by C-section. That surgery leaves a small scar (scar tissue) in the uterine wall. In the next pregnancy, if the embryo implants in or near that scar, the placenta will develop on top of that scar, not in healthy uterine tissue. Because scar tissue doesn't stretch like normal uterine tissue, the placenta is more likely to attach abnormally deep.
Simply put, the more C-sections you have, the more likely you are to develop Placenta Accreta.
Other risk factors:
In addition to C-section , other surgeries or conditions that cause scarring of the uterus can also increase this risk.
- Myomectomy: Surgery to remove fibroids in the uterus.
- Other surgeries performed on the uterus (e.g. Hysteroscopic surgery, Endometrial ablation).
- Having a condition called placenta previa . This means that the placenta is located low in the uterus, covering the cervix. About 80% of people with placenta accreta also have this condition.
- Being over 35 years of age.
- Having given birth to several children before.
How do I find out if I have this condition?
Placenta Accreta is often diagnosed during an ultrasound scan during your normal pregnancy. If you have any of the risk factors mentioned above, your doctor may want to pay special attention to this during the scan.
Sometimes, an MRI scan can be done to determine exactly how deep the placenta is embedded. This information is very important for doctors to plan the delivery.
But remember, sometimes it's hard to tell 100% from scans how severe the condition is. Some mothers are diagnosed with this condition at the time of delivery.
What are the symptoms of this?
The surprising thing here is that there are often no visible symptoms of Placenta Accreta. This condition can develop inside your body without you noticing any changes or discomfort.
However, in very severe cases like Placenta Percreta, the placenta presses on other organs, causing pelvic pain or a small amount of blood in the urine.
What complications can this cause?
The main and most dangerous problem with this condition occurs during childbirth. Since the placenta does not separate from the uterus normally, serious complications can occur.
Possible effects on the baby
- Premature delivery: Depending on the severity of the condition, the baby may need to be delivered by caesarean section 3-6 weeks before the due date.
- Due to premature birth, the baby is at increased risk of needing treatment in the NICU ( Neonatal Intensive Care Unit) .
- If the mother experiences heavy bleeding, the baby may have to be delivered by an unplanned emergency cesarean section.
Possible effects on the mother
In this situation, the main risk lies with the mother.
- Hemorrhage: Severe bleeding, which can be life-threatening, can occur.
- Hysterectomy: In many cases, the only way to stop excessive bleeding and save the mother's life is to completely remove the uterus at the same time as the baby is delivered. This is called a Cesarean Hysterectomy.
How is it treated and managed?
If you are diagnosed with Placenta Accreta, don't panic. Your medical team will develop the best plan to protect you and your baby.
The most important thing is that with this condition, childbirth must definitely take place in a hospital with good facilities. It is essential to have a hospital that can provide blood transfusions and intensive care unit facilities in case of an emergency.
- Planned C-section: A planned C-section is performed a few weeks before the due date.
- Cesarean Hysterectomy: Often, after the baby is delivered, the uterus is completely removed along with the placenta. After this, you will no longer be able to have children. Although this is a sad thing, it is important to understand that it is a necessary step to save the mother's life.
- Talk to your medical team: Before your baby is born, talk to your doctor and medical team about any questions you may have. Talk about breastfeeding after surgery and opportunities to hold your baby close.
In some cases, if the mother wants to have more children, doctors may try to leave part of the placenta in the uterus. However, this carries a risk of infection and subsequent surgery. The best decision about this is made by your medical team based on your situation.
Take-Home Message
- Placenta Accreta is when the placenta attaches too deeply to the uterine wall.
- A major risk factor for this is a previous C-section surgery.
- Often, this condition does not have any visible symptoms. It is diagnosed through an ultrasound scan.
- If this is the case, the delivery should definitely be planned and carried out in a hospital with good facilities.
- Hysterectomy is often performed as a treatment after childbirth.
- If you have any questions, fears, or doubts about this, discuss them openly with your doctor .
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