Health
Fact-checked

At TheHealthBoard, we're committed to delivering accurate, trustworthy information. Our expert-authored content is rigorously fact-checked and sourced from credible authorities. Discover how we uphold the highest standards in providing you with reliable knowledge.

Learn more...

What is Placenta Accreta?

Caitlin Kenney
Caitlin Kenney

Placenta accreta is a medical condition in which a pregnant woman’s placenta binds too deeply and firmly with her uterine wall. The placenta is a slab-like organ that sits against the inner wall of the uterus and ferries nutrients and oxygen from a mother to a developing fetus via the umbilical cord. Normally, the placenta begins developing upon conception, binds to the endometrium, or innermost layer, of the uterus, and is finally expelled from the body during childbirth. Women who develop placenta accreta, however, often have difficulty expelling the placenta after the child is born and may need surgery to dislodge the placenta. The condition may cause the patient to suffer severe blood loss, require a hysterectomy, or even die in extreme cases.

The uterus, or womb, is a muscular female reproductive organ with four layers; the peritoneum, perimetrium, myometrium, and endometrium. In a healthy reproductive process, the fertilized egg binds to the endometrium and, from the egg, both the fetus and the placenta develop. When the baby is born, the muscular layer of the uterus, the myometrium, contracts to help eject the baby from the body. After the baby is born, the mother’s body will push out the bloody lining and the placenta, which will still be attached to the baby through the umbilical cord, if it hasn’t been cut already.

Placenta accreta occurs in pregnant women whose placenta binds with the uterine wall.
Placenta accreta occurs in pregnant women whose placenta binds with the uterine wall.

For unknown reasons, roughly one in 25,000 pregnant women develop placenta accreta. Because it is difficult to diagnose placenta accreta or see it in an ultrasound, this condition usually goes unnoticed until the delivery. Risk factors include placenta previa and history of Cesarean sections. Placenta previa occurs when the placenta is attached to the lower part of the uterus, instead of the upper portion. This condition may cause severe vaginal bleeding before or during delivery as the cervix, the opening at the bottom of the uterus, expands to allow the baby to be expelled. Placenta previa is usually diagnosed in time to take necessary precautions, including preparing for the increased risk of placenta accreta.

The process binds too deeply and firmly with the uterine wall during placenta accreta.
The process binds too deeply and firmly with the uterine wall during placenta accreta.

There are three forms of placenta accreta, classified based on the depth of invasion into the uterine wall. If the condition is referred to simply as placenta accreta, it implies the least severe form, in which the placenta is bound too deeply in the endometrium, but has not invaded the myometrium. This is the most common of the three, comprising roughly 75% of all placenta accreta cases. The second most common form, placenta increta, penetrates more deeply into the endometrium, invading the smooth muscle of the uterus. The third, rarest type is placenta percreta, which occurs when the placenta crosses the all layers of the uterus, sometimes binding with another organ and causing grave danger to the patient.

Women who develop placenta accreta often have difficulty expelling the placenta following childbirth.
Women who develop placenta accreta often have difficulty expelling the placenta following childbirth.

Complications of placenta accreta include severe vaginal bleeding, rupture of the uterus, and premature birth. In the case of placenta percreta, the condition may harm not only the uterus, but other organs, such as the bladder, ureters, and kidneys. A physician will generally recommend a Cesarean section to remove the baby and the placenta from the mother, with minimal damage to the mother or child. Because it is dangerous to deliver a baby prematurely, doctors will help patients to carry the baby as long as possible before scheduling the delivery.

Complications caused by placenta accreta may prompt doctors to deliver a baby by C-section.
Complications caused by placenta accreta may prompt doctors to deliver a baby by C-section.

Doctors may also recommend a hysterectomy, the surgical removal of the uterus, to prevent the possibility of severe hemorrhaging. If the uterus is removed, the mother will no longer have the ability to conceive, but the operation will greatly increase her chances of surviving. In some patients, placenta accreta may be mild enough that the doctor can surgically remove the placenta and stem the flow of blood while keeping the uterus intact. Still, a hysterectomy is usually the safer choice, particularly because most cases are found during delivery, when action must be taken quickly.

Discussion Comments

Kat919

It's sadly very true that with placenta accreta, diagnosis usually happens sadly late. My best friend had had a C-section with her first baby and was looking forward to a natural delivery of her second. She hoped for a big family and was thinking of trying homebirth for her planned third child. Well, during her labor she started bleeding like crazy.

Next thing you know, she's back in the OR, but not just for another C-section. She had to have a hysterectomy. So when she should have been celebrating her new baby, she was also mourning the younger siblings he would never have.

Post your comments
Login:
Forgot password?
Register:
    • Placenta accreta occurs in pregnant women whose placenta binds with the uterine wall.
      By: LanaK
      Placenta accreta occurs in pregnant women whose placenta binds with the uterine wall.
    • The process binds too deeply and firmly with the uterine wall during placenta accreta.
      By: Patricia Hofmeester
      The process binds too deeply and firmly with the uterine wall during placenta accreta.
    • Women who develop placenta accreta often have difficulty expelling the placenta following childbirth.
      By: Olesia Bilkei
      Women who develop placenta accreta often have difficulty expelling the placenta following childbirth.
    • Complications caused by placenta accreta may prompt doctors to deliver a baby by C-section.
      By: Anton Booysen
      Complications caused by placenta accreta may prompt doctors to deliver a baby by C-section.
    • Placenta accreta is difficult to see in an ultrasound.
      By: poco_bw
      Placenta accreta is difficult to see in an ultrasound.
    • Complications of placenta accreta involve severe vaginal bleeding and premature birth.
      By: Tyler Olson
      Complications of placenta accreta involve severe vaginal bleeding and premature birth.
    • The placenta is essential to providing a fetus with proper nutrition.
      By: Noel Powell
      The placenta is essential to providing a fetus with proper nutrition.
    • Vaginal ultrasound probes may be inserted into the vagina to obtain an image of the uterus.
      By: zayacsk
      Vaginal ultrasound probes may be inserted into the vagina to obtain an image of the uterus.