- Placenta accreta is a condition in which the placenta is grown down to or through the uterine muscle
- It provides rare symptoms until after the child’s birth
- This will cause the placenta does not dislodge spontaneously after birth and therefore must be removed manually or surgically
- The bleeding can be comprehensive if the uterus does not pull themselves together after the birth. In some cases you can be forced to remove the uterus
What is placenta accreta?
In a pregnancy puts the fertilized eggs implant (implanting) in the thick and nutrient cycling-rich mucous membrane on the inside of the uterus (endometrium). The placenta is formed and grows into this mucous membrane. At birth the placenta detaches itself and is born as a whole. By placenta accreta growing parts of the placenta down through the mucous membrane, into the uterine muscular and sits partially stuck in the muscle wall. At birth the placenta will not be able to be born in the normal way, because some of it has grown into the muscle.
There are three kinds of nedvækst of the placenta. Accreta is the most common and is often used as a generic term.
- Placenta accreta means the placenta grows into the muscle layer of the uterus
- Placenta increta means the placenta grows partially through the muscular layer
- Placenta percreta means the placenta grows down throughout the muscle layer and into the outer membrane outside the uterus (serosa)
How frequent are placenta accreta?
Placenta accreta is rare, but in line with the increasing incidence of Cesarean section, there will be more cases of placenta accreta, too. In the United States it has been calculated that this diagnosis will demonstrate at 1 per 500 to 1 per 2500 births.
What is placenta accreta?
Against this background, the placenta sometimes growing deep into the underlying muscle, is unknown. But we know that it happens a lot more often if the lining of the uterus is damaged or thin. This is evident by the fact that the placenta accreta primarily occurs in women who have scarring in the uterus. Previous Cesarean section is the all-dominant cause of scar tissue in the uterus. Completely at the bottom of the uterus is somewhat thinner than the lining of the uterus in the middle parties, and low-lying placenta therefore also leads to increased risk. In addition, the rising incidence in smokers, in women who have given birth to many children and with increasing age. After artificial insemination is the risk also increased.
What are the symptoms of placenta accreta?
There may in rare cases be constant pain equivalent to placenta location during pregnancy. In most cases, the symptoms are lack of birth of the placenta or heavy bleeding after the birth of the child.
What symptoms you should pay particular attention to?
Constant pain in the lower abdomen during pregnancy or severe bleeding after child birth.
How made the diagnosis?
In pregnancy the pregnant will in most cases do not have any discomfort or symptoms as a result of a jammed placenta. Shortly after giving birth to the placenta normally loosen and come out. When the placenta not loosens itself, this usually leads to severe and persistent bleeding. This can be a life-threatening situation, but at a hospital with emergency preparedness, access to blood transfusions and intensive treatment, it could be treated.
Placenta accreta is being increasingly discovered in connection with ultrasound examination. But not all cases can be found by ultrasound. Therefore, we must continue to have preparedness for this diagnosis by births.
What treatment is there?
If the diagnosis is made in advance, scheduled as a starting point, the birth must be done by caesarean section, and the procedure is carried out in good time, before the birth goes in time. Since first taking baby out as under ordinary cesarean section and then try to remove the firm grew placenta. This can in some cases be done with hands by loosening the placenta from muscle or by surgical removal of part of the uterus. In other cases, the bleeding uncontrollable, and so one can be obliged to remove the entire uterus.
In cases where the diagnosis will not be made just after the birth, you can try to remove the placenta with your hands through the cervix and subsequently stop the bleeding by placing napkins or a balloon in the uterine cavity. Stops the bleeding is not, it may be necessary to remove the uterus.
Previous Cesarean section or previous operations in the lining of the uterus increases the risk of placenta accreta strongly. It is one of the arguments to avoid caesarean section or other operation through the uterine wall.
How is long-term prospects?
The prognosis for the fetus is good, because bleeding complications usually begins after birth. In those cases where the placenta is grown completely through the uterine muscular, there will be a high risk that you have to remove the uterus. This will be the last resort, as doctors would like to take, since it implies that the woman cannot give birth to more children.
How do I avoid getting or exacerbating placenta accreta?
Avoid surgery through the uterine wall as caesarean or removal of benign fibroids.