Health

Placenta accreta “causes and symptoms”

“The placenta” … is one of the most important parts of pregnancy, and it is the main factor in the growth of the fetus and its nutrition from the mother, and the presence of any defect in it exposes the fetus and its mother to danger.

It works on the connection of the fetus with the endometrium, which is the main responsible for feeding the fetus, and its normal location is on the front, back, right or left wall of the uterine wall.

Placenta accreta. One of the most dangerous situations in which the placenta is during pregnancy, and it cannot be avoided or evaded, because it grows with blood vessels in a way that penetrates the uterine wall.

What is placenta accreta?

Placenta accreta is a serious pregnancy condition that occurs when the placenta grows too deeply into the uterine wall.

Typically, the placenta detaches from the uterine wall after childbirth. With placenta accreta, part or all of the placenta remains attached. This can cause severe blood loss after delivery.

It’s also possible for the placenta to invade the muscles of the uterus (placenta increta) or grow through the uterine wall (placenta percreta).

Placenta accreta is considered a high-risk pregnancy complication. If the condition is diagnosed during pregnancy, you’ll likely need an early C-section delivery followed by the surgical removal of your uterus (hysterectomy).

Symptoms of placenta accreta during pregnancy: (what the mother will experience).

1. No symptoms: Although this anomaly occurs at the beginning of the pregnancy itself, it does not cause any problem until the time of delivery as the function of the placenta is very normal. Even if it’s related to placenta previa (where the placenta is partially or completely covered in the lower region of the uterus), there is a 21.7% chance that no bleeding will ever occur.

2. Vaginal bleeding: If you have placenta previa, you may experience vaginal bleeding in the third trimester. The first bleeding episode may occur before 30 weeks (33.7% chance), after 30 weeks (44.6% chance), or not at all (21.7%).

3. Premature labor: Not due to placenta accreta itself but if it is related to placenta previa then there is a 44% chance of delivery before 37 weeks.Therefore, if you are experiencing vaginal bleeding or uterine pain and contractions in the third trimester, it is important to see your doctor.

Signs of placenta accreta: (what the doctor will notice).

If not diagnosed before the baby is born, placenta accreta will appear as follows:

1. Delayed delivery of the placenta: The placenta usually detaches spontaneously and is expelled within 30 minutes of delivery. In placenta accreta, the placenta fails to come out spontaneously and this will ring a doctor for possible placenta accreta.

2. Profuse vaginal bleeding: Your doctor will notice more vaginal bleeding than normal, especially when trying to manually separate the placenta.

3. Flaccid uterus: Usually after the birth of a baby, the uterus begins to harden. This also compresses the blood vessels and stops the bleeding. With placenta accreta and if not expelled, the uterus remains soft and as a result, bleeding continues.Low blood pressure and increased pulse rate: This occurs when there is excessive blood loss.

Types of placenta accreta.

There are several types of placenta accreta in the uterus, and they are as follows:

▪️ Simple placenta accreta, an adhesion of the placenta within the muscles of the uterus without penetration.

▪️ The placenta is attached to the muscles, in which case the ends of the placenta penetrate the muscles of the uterus from the inside.

▪️ Penetrating placenta, one of the most dangerous types of placenta accreta, in addition to it poses a great danger to the health of the mother and the fetus, in this case the placenta villi penetrate the uterine muscles completely and may come out of the uterus and also may cause a perforation of the urinary bladder.

Causes of placenta accreta.

There are a number of reasons for the placenta to stick to the uterine wall:

1. High blood pressure for a pregnant woman.

2. Gestational diabetes.

3. Twin pregnancy.

4. Frequent cesarean delivery.

5. Previous uterine surgery.

6. Recurrent miscarriage.

7. The occurrence of attachment of the placenta in a previous pregnancy.

Risk factors.

Many factors can increase the risk of placenta accreta, including:

▪️ Previous uterine surgery. The risk of placenta accreta increases with the number of C-sections or other uterine surgeries you’ve had.

▪️ Placenta position. If the placenta partially or totally covers your cervix (placenta previa) or sits in the lower portion of your uterus, you’re at increased risk of placenta accreta.

▪️ Maternal age. Placenta accreta is more common in women older than 35.

▪️ Previous childbirth. The risk of placenta accreta increases as your number of pregnancies increases.

Complications.

Placenta accreta can cause:

1. Heavy vaginal bleeding.

Placenta accreta poses a major risk of severe vaginal bleeding (hemorrhage) after delivery. The bleeding can cause a life-threatening condition that prevents your blood from clotting normally (disseminated intravascular coagulopathy), as well as lung failure (adult respiratory distress syndrome) and kidney failure. A blood transfusion will likely be necessary.

2. Premature birth.

Placenta accreta might cause labor to begin early. If placenta accreta causes bleeding during your pregnancy, you might need to deliver your baby early.

Treatment.

If your health care provider suspects placenta accreta, he or she will work with you to develop a plan to safely deliver your baby.

In the case of extensive placenta accreta, a C-section followed by the surgical removal of the uterus (hysterectomy) might be necessary. This procedure, also called a cesarean hysterectomy, helps prevent the potentially life-threatening blood loss that can occur if there’s an attempt to separate the placenta.

If you have vaginal bleeding during the third trimester, your health care provider might recommend pelvic rest or hospitalization.

References :

المشيمة الملتصقة: الأسباب والأعراض والمخاطر والعلاج/ https://arabiaparenting-firstcry-com

أنواع المشيمة الملتصقة بالرحم/ https://e3arabi-com

المشيمة الملتصقة الأعراض والأسباب / www.mayoclinic.org

المشيمة الملتصقة التشخيص والعلاج / www.mayoclinic.org

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