By The Well-Rounded Mama, August 26, 2013
Placenta Accreta, Part One: What Is Accreta?
Read the full article here.
Placenta accreta comes in three levels of severity ─ accreta, increta, and percreta.
Thankfully, most accretas don’t involve an increta or a percreta. However, even without these severe forms, an accreta is still a very serious complication that has the potential to become life-threatening.
Fortunately, foreknowledge of an accreta, careful management protocols, and being in the right delivery setting can significantly lower the risk of mortality and morbidity. So if you have been told that you have an accreta, don’t panic. Chances are that you and your baby will be okay.
However, you need to know that a significant blood loss is likely, a transfusion may be needed, and a hysterectomy is a distinct possibility (depending on the severity of the accreta). In the most severe cases, nearby organs may be damaged as well. Management and delivery at a large regional hospital with OBs that are very experienced with dealing with accretas will optimize your chances for the best outcomes.
Sadly, the incidence of accretas has increased in parallel with the rising cesarean rate. This is because scarring and damage to the uterine lining during a cesarean predisposes to abnormal placentation. Indeed, the more cesareans a woman has, the higher her risk for placenta accreta.
Some risk factors for accretas cannot be controlled, but a high underlying cesarean rate is a risk factor that is preventable on a population-wide basis, and routine repeat cesareans is a risk factor that is highly preventable on an individual basis.
Placenta accreta is an extremely serious complication that is becoming all too common. A casual attitude towards cesareans, an over-utilization of them in low-risk mothers, and a lack of access to Vaginal Birth After Cesarean (VBAC) is part of the cause.
This is yet another reason why reducing the cesarean rate and keeping access to VBAC is so important.