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 34 of pregnancy to avoid an unscheduled emergency delivery.
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.
After a hysterectomy, you no longer have the ability to become pregnant. If you had planned to become pregnant again in the future, discuss possible options with 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.
March 28, 2015
- Wortman AC, et al. Placenta accreta, increta, and percreta. Obstetrics and Gynecology Clinics of North America. 2013;40:137.
- Creasy RK, et al. Placenta previa, placenta accreta, abruptio placentae, and vasa previa. In: Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 7th ed. Philadelphia, Pa.: Saunders Elsevier; 2014. http://www.clinicalkey.com. Accessed Feb. 3, 2015.
- Cunningham FG, et al. Placental abnormalities. In: Williams Obstetrics. 24th ed. New York, N.Y.: The McGraw-Hill Companies; 2014. http://www.accessmedicine.com. Accessed Feb. 3, 2015.
- Resnik R. Clinical features and diagnosis of placenta accreta, increta, and percreta. http://www.uptodate.com/home. Accessed Feb. 4, 2015.
- Eshkoli T, et al. Placenta accreta: Risk factors, perinatal outcomes, and consequences for subsequent births. American Journal of Obstetrics and Gynecology. 2013;208:219e1.
- Resnik R. Management of placenta accreta, increta, and percreta. http://www.uptodate.com/home. Accessed Feb. 4, 2015.
- Legendre G, et al. Conservative management of placenta accreta: Hysteroscopic resection of retained tissues. The Journal of Minimally Invasive Gynecology. 2014;21:910.
- Relaxation techniques for health: An introduction. National Center for Complementary and Integrative Health. https://nccih.nih.gov/health/stress/relaxation.htm. Accessed Feb. 5, 2015.
- Wick MJ (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 19, 2015.
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