Placenta accreta suspicion: When does it arise and what does it mean?
Placenta accreta suspicion most often comes up during an ultrasound, especially if you’ve had a previous cesarean section or uterine surgery. Placenta accreta means the placenta is attached too deeply to the uterine wall, making separation at birth difficult and increasing the risk of serious bleeding.
If your doctor mentions the possibility of placenta accreta, the first step is a thorough diagnosis and close monitoring. Remember, suspicion is not the same as a confirmed diagnosis—further tests are usually needed. It’s natural to feel uncertain or worried, but today’s obstetric care is designed to keep you and your baby safe.
What is placenta accreta? 🩸
Placenta accreta is a rare but serious pregnancy complication where the placenta embeds itself more deeply than normal into the uterine wall. Normally, the placenta attaches to the inner surface of the uterus and separates after birth. With accreta, the attachment is too strong, making separation difficult or impossible and leading to significant bleeding.
Biological background
The placenta’s job is to deliver nutrients and oxygen to your baby. If the uterine lining (endometrium) is damaged—such as after surgery, cesarean section, or dilation and curettage—the placenta can more easily invade the muscle layer (myometrium). This abnormal attachment is part of the placenta accreta spectrum, which can range in severity (increta, percreta).
When is placenta accreta suspected?
Suspicion of placenta accreta most often arises in these situations:
- During ultrasound: If the placenta is low-lying or shows unusual attachment signs.
- Previous cesarean section: The risk increases with multiple cesareans.
- Uterine surgery history: After procedures like dilation and curettage, myomectomy, or other uterine surgeries.
- Placenta previa: If the placenta covers the cervix partially or completely, abnormal attachment is more likely.
Practical examples
- A 32-year-old expectant mother with two prior cesarean deliveries is diagnosed with placenta previa at her 20-week ultrasound. Her doctor pays special attention to attachment signs and raises the possibility of placenta accreta.
- In another case, after a previous uterine procedure, the placenta is found low in the uterus and the normal boundary between placenta and uterine wall is not visible on ultrasound.
What symptoms may point to placenta accreta?
Placenta accreta is often silent during pregnancy. Most cases are suspected only through imaging (ultrasound, MRI). Rarely, you might notice:
- Unusual, repeated bleeding in the second or third trimester
- Signs of placenta previa
- Pain or pressure in the lower uterus
Important: These symptoms are not unique to placenta accreta and can have other causes.
How is placenta accreta diagnosed?
Diagnosis usually involves:
- Ultrasound: Suspicion arises based on the location of the placenta and the structure of the uterine wall.
- MRI: If ultrasound is unclear, MRI can help determine the extent of attachment.
- Specialist consultation: Multiple obstetricians may be involved to decide on next steps.
Possible risks and complications
The main risk of placenta accreta is severe bleeding during delivery, which may require blood transfusion, surgery, or even hysterectomy. Early detection and careful birth planning are essential.
Risk factors
- Multiple cesarean sections
- Uterine surgery history
- Placenta previa
- Age over 35
When should you contact your doctor?
Contact your obstetrician immediately if:
- Placenta accreta is suspected on ultrasound
- You experience unusual bleeding during pregnancy
- You feel strong pain or pressure in your lower uterus
- You have a history of cesarean section or uterine surgery and signs of placenta previa
Regular medical checkups and close monitoring help ensure a safe pregnancy and delivery.
What can you do if placenta accreta is suspected?
- Stay in close contact with your obstetrician and follow their recommendations.
- Ask questions if you’re unsure about tests or possible risks.
- Keep track of your symptoms and report them to your doctor.
- Avoid strenuous physical activity until diagnosis is clear.
Emotional support and reassurance 🤗
Suspecting placenta accreta can be frightening, but you’re not alone. Modern obstetric care is well prepared for these situations, and you’ll receive support every step of the way. If you’re worried, talk about your feelings, ask for help, and know that your care team is focused on keeping you and your baby safe.
For more expert tips, guides, and reassurance, our free app offers even more information to help you feel confident and secure throughout your pregnancy.