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 part or all of the placenta remains attached after delivery.
A cesarean hysterectomy should be done at a hospital that has an intensive care unit and is equipped to handle complications, such as severe bleeding. Your health care team for the surgery might include an obstetrical surgeon, a pelvic surgeon and an anesthesiologist, as well as a neonatologist to treat your baby.
Your health care provider might recommend scheduling the C-section and hysterectomy as early as week 35 of pregnancy to avoid an unscheduled delivery. To evaluate the maturity of your baby's lungs, your health care provider might test a sample of amniotic fluid — the fluid that surrounds and protects a baby during pregnancy. This test is known as maturity amniocentesis.
During the C-section, your health care provider will deliver your baby through an incision in your abdomen and a second incision in your uterus. After delivering your baby, your health care provider or another member of your health care team will remove your uterus — with the placenta still attached — to prevent severe bleeding.
A hysterectomy ends your ability to become pregnant. If you had planned to become pregnant again in the future, consult your health care provider.
Rarely, the uterus and placenta might be allowed to remain intact, allowing the placenta to dissolve over time. However, this approach can have serious complications, including:
- Severe vaginal bleeding
- A blood clot that blocks one or more arteries in the lungs (pulmonary embolism)
- The need for a hysterectomy at a later date
In addition, limited research suggests that women who are able to avoid hysterectomy after having placenta accreta are at risk of pregnancy complications with subsequent pregnancies, including miscarriage, premature birth and recurrent placenta accreta.
If you're interested in uterine conservation, ask your health care provider if it's a possibility for you. If so, he or she can help you weigh the risks and benefits.
May. 24, 2012
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