What are placenta previa and accreta? Placenta previa and placenta accreta are two placental conditions that can cause complications during pregnancy. What are the ins and outs of these conditions, their risk factors, treatment options, and their impact on future pregnancies.
Key Takeaways:
- Understand the types, causes and risks of placenta previa & accreta.
- Diagnosis involves ultrasound/Doppler sonography. Treatment options range from monitoring to surgery.
- Prevent future issues by being aware of risk factors & taking preventative measures like avoiding multiple Csections and maintaining a healthy lifestyle.
Understanding Placenta Previa
A healthy pregnancy relies on the proper functioning of the placenta, a vital organ that provides oxygen and nutrients to the growing baby. Placenta previa is a condition where the placenta partially or completely covers the cervix, the opening to the uterus. It can be categorized into three types: complete, partial, and marginal placenta previa. This abnormal positioning can lead to potential complications, such as painless vaginal bleeding and premature birth.
It’s worth noting that placenta previa can be associated with more severe forms of placental invasion, such as placenta accreta, increta, and percreta. These conditions involve the placenta invading the uterine wall more deeply than it should, causing potential complications during delivery. Early diagnosis and proper management are crucial to ensure the well-being of both mother and baby.
Causes of Placenta Previa
So, what causes placenta previa? Some potential factors include uterine scarring and an unusual uterus shape, which may involve abnormalities in the uterine wall. Uterine scarring can result from prior cesarean sections, uterine surgeries, or other traumas to the uterus, increasing the risk of placenta accreta.
Moreover, fibroids, polyps, or other uterine abnormalities could lead to an abnormal uterus shape, which might cause conditions like partial placenta previa. Other risk factors include having an older mother, multiple pregnancies, and previous uterine surgeries, as reported in various obstetrical and gynecological studies.
Symptoms and Diagnosis of Placenta Previa
The most common symptom of placenta previa is painless vaginal bleeding. However, it’s crucial to obtain a proper diagnosis to prevent maternal morbidity associated with this condition. Ultrasound is considered to be the gold standard for diagnosing placenta previa. Sometimes, it is used in combination with Doppler sonography for better diagnosis.
While placenta accreta may not always present with symptoms, some cases may involve bleeding or pelvic pain. To diagnose placentation disorders, including cesarean scar pregnancy, healthcare professionals rely on ultrasound and Doppler sonography. Timely diagnosis is essential for planning the appropriate management and care during pregnancy and delivery.
Understanding Placenta Accreta
Placenta accreta occurs when the placenta invades the uterine wall more deeply than it should, extending beyond the decidua basalis. It can be further classified into three forms: accreta, increta, and percreta, with magnetic resonance imaging (MRI) being helpful in diagnosing these conditions. Placenta increta, for instance, involves the placenta invading the uterine myometrium.
Unfortunately, placenta accreta can lead to complications during pregnancy, such as bleeding, premature birth, and the need for a hysterectomy. It’s important to be aware of the potential issues related to the placenta accreta spectrum, which include the risk of bleeding during labor and delivery and even after.
Healthcare professionals must be vigilant in monitoring and managing clinical risk factors to ensure a safe pregnancy and delivery experience, as outlined in the “j obstet gynecol” journal.
Causes of Placenta Accreta
What factors contribute to the development of placenta accreta? Previous cesarean deliveries and advanced maternal age are known to increase the risk of this condition. The risk of placenta accreta in a subsequent pregnancy after a C-section is quite small, at only 0.24%. However, it still needs to be taken seriously.
It’s essential to be aware of these risk factors to help identify and manage placenta accreta early in pregnancy. Healthcare professionals must work closely with the expectant mother to monitor her condition and develop an appropriate plan of care, keeping in mind the potential complications and challenges that may arise during labor and delivery.
Symptoms and Diagnosis
Placenta accreta may be asymptomatic or present with bleeding. When suspecting placenta percreta, Doppler sonography can be a helpful diagnostic tool. To diagnose placenta accreta and its various forms, ultrasound and MRI are the preferred methods.
In cases of heavy bleeding or pelvic pain during pregnancy with placenta accreta, it’s crucial to seek immediate medical attention by calling 911. Early diagnosis and appropriate management of placenta accreta can help prevent life-threatening blood loss and the potential need for a hysterectomy. Consult an obstet gynecol specialist for the best course of action.
Risk Factors for Both Conditions
While placenta accreta and previa are distinct conditions, they share some common risk factors. Prior uterine surgery, multiple pregnancies, and smoking are all risk factors for both placenta accreta and previa. In the case of placenta previa, additional risks include previous uterine scars, advanced maternal age, and multiparity, as well as smoking, cocaine use, and previous C-section deliveries.
For placenta accreta, having prior uterine surgery, multiple pregnancies, and smoking are also known risk factors. Being aware of these risk factors can help healthcare professionals and expectant mothers take necessary precautions and plan appropriate care during pregnancy and delivery.
Treatment Options
Treatment for placenta previa and accreta varies depending on the severity of the condition and the individual needs of the patient. Close monitoring, bed rest, and a planned cesarean delivery are some of the management options available. In more severe cases, a hysterectomy may be necessary to ensure the safety of the mother and baby.
The choice of treatment depends on various factors, such as the extent of placental invasion, the presence of vaginal bleeding, and the gestational age of the fetus. It’s essential for healthcare professionals to work closely with the expectant mother to develop a tailored plan of care that addresses her unique needs and concerns.
Conservative Management
Non-surgical treatment options for placenta accreta and previa include blood transfusion and uterine artery embolization. These conservative management approaches aim to remove the placenta or uteroplacental tissue without removing the uterus.
While the effectiveness of conservative treatments for the placenta accreta spectrum is still unclear, they can be considered as potential options for patients who wish to preserve their fertility. It’s crucial for healthcare professionals to weigh the risks and benefits of these treatment options and discuss them with the patient to make an informed decision.
Surgical Interventions
In more severe cases of placenta accreta and previa, surgical interventions such as cesarean hysterectomy and delayed interval hysterectomy may be required. A cesarean hysterectomy involves the removal of the uterus during a C-section delivery.
The choice of surgical intervention depends on the patient’s individual circumstances and the severity of the placental disorder. Healthcare professionals must carefully assess the situation and consider the potential risks and benefits of each surgical option before proceeding. Ultimately, the goal is to ensure the safety and well-being of both the mother and baby during delivery.
Impact on Future Pregnancies
Experiencing placenta previa or accreta can have implications for future pregnancies. The recurrence risk of placenta accreta spectrum after expectant management is 28,6%. The ability to conceive again largely depends on whether a hysterectomy was performed or not.
In cases where fertility is preserved, it’s important for women with a history of placenta accreta or previa to be closely monitored during subsequent pregnancy. Healthcare professionals should be vigilant in identifying and managing potential complications to ensure a safe and healthy pregnancy experience.
Prevention Strategies
While there are no specific prevention strategies for placenta previa, being aware of the risk factors for both placenta accreta and previa can help reduce their occurrence in future pregnancy. Avoiding multiple cesarean deliveries, for instance, can lower the risk of developing these conditions.
Maintaining a healthy lifestyle, including eating a balanced diet and exercising regularly, can also help lower the chances of having placenta accreta and previa. By taking these precautions and working closely with healthcare professionals, expectant mothers can increase their chances of enjoying a safe and healthy pregnancy journey.
Understanding the complexities of placenta accreta and previa is crucial for managing these conditions during pregnancy. By being aware of the risk factors, seeking appropriate diagnostic methods, and exploring various treatment options, expectant mothers and healthcare professionals can work together to ensure a safe and healthy pregnancy experience. Remember, knowledge is power, and staying informed about these placental disorders can pave the way for a smoother and more rewarding journey into parenthood.
Frequently Asked Questions
What is the difference between placenta previa and accreta?
Placenta previa is a condition where the placenta grows in the lower portion of the uterus and partially or fully covers the cervix.
Placenta accreta, on the other hand, is an uncommon complication which occurs when the placenta becomes abnormally attached to the uterus wall, usually due to complications from placenta previa.
What happens if you have placenta accreta?
If you have placenta accreta, it can be life-threatening for both mother and baby. Possible risks associated with this condition include severe bleeding, preterm delivery, blood transfusion, extended hospital stay, and intensive care unit admission.
It’s important to seek medical attention if you think you may be at risk.
What is the most common cause of placenta accreta?
The most common cause of placenta accreta is a previous history of cesarean deliveries or other uterine surgery, which can lead to an abnormal buildup of scar tissue in the uterus.
This scar tissue can make it difficult for the placenta to detach from the uterus after delivery, leading to placenta accreta.
What is placenta previa caused by?
Placenta previa is caused by the placenta being positioned low in the uterus, covering all or part of the cervix. This usually occurs due to a random event during pregnancy and it cannot be prevented.
How are placenta previa and accreta diagnosed?
Placenta previa and accreta can both be detected with the help of ultrasound scans, often before the 20th week of pregnancy. In cases where ultrasound is inconclusive, doctors may recommend MRI scans for further analysis.
