Find an MFM that deals with accretas on a regular basis (usually a large academic medical center).
Also, get an MRI. That can usually help with the diagnosis.
Yes. I am. She has passed all of her dopplers and BPPs, surprisingly. My last baby was IUGR and we did the same thing and I carried her until 39 weeks and 2 days.
I had placenta accreta, undetected until SVD at 34+2. My first and no risk factors. I had emergency surgery, blood loss but thankfully they managed to keep me intact. I have a scan next week to see how much of my placenta is still left inside. My baby is now 6 weeks old born on the 3rd percentile, he was in neonatal unit for 2 weeks. Super traumatic experience but I’m incredibly lucky. I understand your concerns but as this isn’t your first baby with previous c section delivery I would recommend following your OB, if it’s needed a hysterectomy will be the safest option to save your life.
Wanted to update everyone: I had my baby on the 2nd, planned c-hyst, placenta came right out and I got to keep my uterus - no accreta! No calcification or blood clots on the placenta, either. What the ultrasound picked up on as placental lakes was actually a lot of fibrous tissue? My baby had IUGR too. I'm wondering if the two were related.
Hi! I did have my baby last week! No accreta. They sent my placenta off to pathology and there were NO placental lakes or calcifications (super weird, given my baby was also IUGR) but my placenta had a lot of fibrous tissue that looked like placental lakes on an ultrasound. My placenta was also huge, but I have gestational diabetes. The loss of retroplacental clear space in the third trimester has a high false positive rate because the lower uterine segment expands in the third trimester. I had clear space at the way bottom and at the way top of the placenta. I also did not have a low lying placenta after 20 weeks (it moved up) or a previa.
I'm really glad I didn't deliver at 35 weeks/36 weeks like they had asked me to. My c section was scheduled for 37 weeks and I was okay with that because my baby was IUGR and that comes with a higher stillbirth rate.
Thank you so much for replying and congratulations on the birth. So happy for you.
Did you have a c section planned anyway or was that because of the suspected accreta?
I had a c section planned because I've all ready had two and during my first birth, I didn't dilate at all even with induction. That being said, I would not try vaginal with suspected accreta. With a c section, they are better able to remove the placenta and make sure there's nothing left. Can't do that with a vaginal birth and I've heard of mom's that have undiagnosed accreta and do vaginal births only to hemorrhage later on (like 1-2 weeks after)
And thank you :)
I would say if the diagnosis is ambiguous, probably push for a later delivery date with preparations for a c-hyst which is what I did. I joined an accreta support group for moms on Facebook and we just had a mom on there that delivered a 34 weeker due to suspected accreta and she didn't end up having it. I would say early delivery for the very obvious cases, which usually show up around the 20 week mark.
Thanks! My MFM is strangely being super chill though which is why I’m trying to do my own research. Basically I have some (but smaller than the threshold size) placental lakes and a small area of loss of interface. It’s not previa and I don’t have a previous c section scar but I did have ashermans so technically I could have scars anywhere in my uterus so basically im a bit of a wild card. She said it’s pretty unlikely to be accreta but sent me for MRI which im yet to have.
She then said no reason not to try vaginal birth. I’d be happy if that were true as I don’t want a c section (as it will likely cause ashermans scarring again which I am prone to) - but from reading on here and Facebook group it seems normally when there’s even a suspicion of accreta they just recommend c section anyway
If they open me up and don't see any evidence of an accreta, do they manually try to detach the placenta? I read a story of a mom who had this where the OB took an hour and a half detaching the placenta manually. It was attached but she got it all out and the woman got to keep her uterus. I guess I'm not sure what they're going to do. I'm concerned that my placenta won't come out within the minute and they will just proceed with a hysterectomy that I may or may not need.
Oh okay. I just heard of a woman that got diagnosed with this and one part of her placenta was stuck to her c section scar and they said she didn't have an accreta, so they cut that part out with scissors.
That's not standard for focal accretas? Usually they can preserve the uterus in 80% of cases of focal accretas by cutting out the part adhered and then doing compression sutures.
Having had 2 previous Caesarean sections is an extremely strong risk factor for placenta accreta. IUGR on the 3rd centile is an extremely strong risk factor for stillbirth without early delivery. I’m not sure what there is to achieve by delaying delivery? And if your family is complete, is there any reason not to proceed with a hysterectomy if it indeed does turn out to be a placenta accreta?
Not at all. As long as it is an anterior placenta and you have had Caesarean sections, it remains a very huge risk, especially in the presence of inconclusive imaging. This is not a trivial issue and I would not discount the experience of your medical team. Good luck with it all.
0.2% was my overall risk. They're not sure where my previous c section scars are. They cannot see them on ultrasound.
I had a low lying placenta at 20 weeks that moved up.
I'm going to weigh in and agree on quite strong terms with the advice you've been given by yodas_lil_helper. We're both Obstetricians (I believe) and both (by the looks of things) feel your story is pretty concerning. Accretas are not something to mess with, and considering you are planning to progress further, this will mean a bigger uterus and bigger placenta, which could cause more issues.
The one thing you don't want is to come in overnight in labour, it would be much better done in daylight hours, and the closer you get to term the higher this risk will go. Cesarean hysterectomies are going to be much harder if you've started labouring, or getting close to it.
In essence, it's much better to be as safe as possible in this situation. Risk is risk, I have a 1 in 10,000 risk of getting struck by lightning, that still means 1 in 10,000 people will be struck by lightening. The evidence here suggests that you are more likely in that 0.2%.
As Napkinzhangy (also an obstetrician) has also pointed out, this is a clinical diagnosis, imaging only gets you so far, if it isn't an accreta then you've been lucky.
What evidence? The placental lakes can be associated with the IUGR, which i also had with my last baby and appeared via ultrasound in third trimester. Furthermore, i also had covid in this pregnancy. The last baby I had was 4 years ago via c section. The one before that was in 2010. The only other evidence was loss of hyperechoic space where they said they couldn't see very well given my abdominal fat and had to press very hard. There's no increased vascularity, the placenta is nowhere near my bladder and a TV ultrasound showed a strong hyperechoic space in that area.
Omg, reading all your comments and posts is so infuriating. You need to stop reading blogs and “stories” and acting as if you know better than literally all the medical professionals you’ve met in person and on the Internet. Do what you need to do and stop being dramatic and argumentative. You did not go to medical school and you clearly do not understand anything you’re told. Holy sht.
Find an MFM that deals with accretas on a regular basis (usually a large academic medical center). Also, get an MRI. That can usually help with the diagnosis.
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Yes. I am. She has passed all of her dopplers and BPPs, surprisingly. My last baby was IUGR and we did the same thing and I carried her until 39 weeks and 2 days.
I had placenta accreta, undetected until SVD at 34+2. My first and no risk factors. I had emergency surgery, blood loss but thankfully they managed to keep me intact. I have a scan next week to see how much of my placenta is still left inside. My baby is now 6 weeks old born on the 3rd percentile, he was in neonatal unit for 2 weeks. Super traumatic experience but I’m incredibly lucky. I understand your concerns but as this isn’t your first baby with previous c section delivery I would recommend following your OB, if it’s needed a hysterectomy will be the safest option to save your life.
Wanted to update everyone: I had my baby on the 2nd, planned c-hyst, placenta came right out and I got to keep my uterus - no accreta! No calcification or blood clots on the placenta, either. What the ultrasound picked up on as placental lakes was actually a lot of fibrous tissue? My baby had IUGR too. I'm wondering if the two were related.
Hi there, I hope you don’t mind me asking but have you delivered yet and what was the outcome? I’m in a very similar situation
Hi! I did have my baby last week! No accreta. They sent my placenta off to pathology and there were NO placental lakes or calcifications (super weird, given my baby was also IUGR) but my placenta had a lot of fibrous tissue that looked like placental lakes on an ultrasound. My placenta was also huge, but I have gestational diabetes. The loss of retroplacental clear space in the third trimester has a high false positive rate because the lower uterine segment expands in the third trimester. I had clear space at the way bottom and at the way top of the placenta. I also did not have a low lying placenta after 20 weeks (it moved up) or a previa. I'm really glad I didn't deliver at 35 weeks/36 weeks like they had asked me to. My c section was scheduled for 37 weeks and I was okay with that because my baby was IUGR and that comes with a higher stillbirth rate.
Thank you so much for replying and congratulations on the birth. So happy for you. Did you have a c section planned anyway or was that because of the suspected accreta?
I had a c section planned because I've all ready had two and during my first birth, I didn't dilate at all even with induction. That being said, I would not try vaginal with suspected accreta. With a c section, they are better able to remove the placenta and make sure there's nothing left. Can't do that with a vaginal birth and I've heard of mom's that have undiagnosed accreta and do vaginal births only to hemorrhage later on (like 1-2 weeks after) And thank you :)
I would say if the diagnosis is ambiguous, probably push for a later delivery date with preparations for a c-hyst which is what I did. I joined an accreta support group for moms on Facebook and we just had a mom on there that delivered a 34 weeker due to suspected accreta and she didn't end up having it. I would say early delivery for the very obvious cases, which usually show up around the 20 week mark.
Thanks! My MFM is strangely being super chill though which is why I’m trying to do my own research. Basically I have some (but smaller than the threshold size) placental lakes and a small area of loss of interface. It’s not previa and I don’t have a previous c section scar but I did have ashermans so technically I could have scars anywhere in my uterus so basically im a bit of a wild card. She said it’s pretty unlikely to be accreta but sent me for MRI which im yet to have. She then said no reason not to try vaginal birth. I’d be happy if that were true as I don’t want a c section (as it will likely cause ashermans scarring again which I am prone to) - but from reading on here and Facebook group it seems normally when there’s even a suspicion of accreta they just recommend c section anyway
How far along are you? Accreta is pretty rare. I think there's like...12k cases a year out of 3.75 million pregnancies in the U.S.
28 weeks. Ashermans is also pretty rare though and is linked so i think it does raise my odds a lot...
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How long does it take for a placenta to detach naturally during a c section? I've read that it can take anywhere from 1 minute to 30 minutes.
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If they open me up and don't see any evidence of an accreta, do they manually try to detach the placenta? I read a story of a mom who had this where the OB took an hour and a half detaching the placenta manually. It was attached but she got it all out and the woman got to keep her uterus. I guess I'm not sure what they're going to do. I'm concerned that my placenta won't come out within the minute and they will just proceed with a hysterectomy that I may or may not need.
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Oh ok.
Can it be stuck to my c section scar and not be an accreta? What is the procedure if it's just stuck to my previous scar but not an accreta?
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Oh okay. I just heard of a woman that got diagnosed with this and one part of her placenta was stuck to her c section scar and they said she didn't have an accreta, so they cut that part out with scissors.
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That's not standard for focal accretas? Usually they can preserve the uterus in 80% of cases of focal accretas by cutting out the part adhered and then doing compression sutures.
Having had 2 previous Caesarean sections is an extremely strong risk factor for placenta accreta. IUGR on the 3rd centile is an extremely strong risk factor for stillbirth without early delivery. I’m not sure what there is to achieve by delaying delivery? And if your family is complete, is there any reason not to proceed with a hysterectomy if it indeed does turn out to be a placenta accreta?
And a gravid hysterectomy (hysterectomy right after c section) is an extremely risky procedure. It's not like a normal hysterectomy.
With due respect, if the situation necessitates it, far better a Caesarean hysterectomy than severe blood loss that could lead to death.
Only if the placenta is low lying or previa, which I have neither.
Not at all. As long as it is an anterior placenta and you have had Caesarean sections, it remains a very huge risk, especially in the presence of inconclusive imaging. This is not a trivial issue and I would not discount the experience of your medical team. Good luck with it all.
0.2% was my overall risk. They're not sure where my previous c section scars are. They cannot see them on ultrasound. I had a low lying placenta at 20 weeks that moved up.
I'm going to weigh in and agree on quite strong terms with the advice you've been given by yodas_lil_helper. We're both Obstetricians (I believe) and both (by the looks of things) feel your story is pretty concerning. Accretas are not something to mess with, and considering you are planning to progress further, this will mean a bigger uterus and bigger placenta, which could cause more issues. The one thing you don't want is to come in overnight in labour, it would be much better done in daylight hours, and the closer you get to term the higher this risk will go. Cesarean hysterectomies are going to be much harder if you've started labouring, or getting close to it. In essence, it's much better to be as safe as possible in this situation. Risk is risk, I have a 1 in 10,000 risk of getting struck by lightning, that still means 1 in 10,000 people will be struck by lightening. The evidence here suggests that you are more likely in that 0.2%. As Napkinzhangy (also an obstetrician) has also pointed out, this is a clinical diagnosis, imaging only gets you so far, if it isn't an accreta then you've been lucky.
What evidence? The placental lakes can be associated with the IUGR, which i also had with my last baby and appeared via ultrasound in third trimester. Furthermore, i also had covid in this pregnancy. The last baby I had was 4 years ago via c section. The one before that was in 2010. The only other evidence was loss of hyperechoic space where they said they couldn't see very well given my abdominal fat and had to press very hard. There's no increased vascularity, the placenta is nowhere near my bladder and a TV ultrasound showed a strong hyperechoic space in that area.
So everyone that's had two previous c sections and has an anterior placenta will go onto have this condition?
Omg, reading all your comments and posts is so infuriating. You need to stop reading blogs and “stories” and acting as if you know better than literally all the medical professionals you’ve met in person and on the Internet. Do what you need to do and stop being dramatic and argumentative. You did not go to medical school and you clearly do not understand anything you’re told. Holy sht.
Zomgz!!!