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Placenta Accreta: A Serious Pregnancy Complication
24
Nov
Nov
What is Placenta Accreta?
Placenta accreta is a serious pregnancy complication where the placenta grows too deeply into the wall of the uterus and, in severe cases, can invade nearby organs like the bladder. Normally, the placenta detaches easily after childbirth, but with placenta accreta, removal becomes dangerous and can cause severe bleeding, necessitating advanced medical care such as a hysterectomy.
Who Can Get Placenta Accreta?
While placenta accreta is rare, certain factors can increase the risk:
- A history of placenta previa (placenta covering the cervix).
- Previous cesarean deliveries or uterine surgeries.
- Multiple pregnancies or advanced maternal age.
The Risks of Placenta Accreta
Without proper diagnosis and treatment, placenta accreta can lead to:
- Severe hemorrhaging during childbirth.
- Damage to surrounding organs.
- The need for emergency surgery, such as a hysterectomy.
- In extreme cases, maternal death.
Why is Placenta Accreta on the Rise?
The increasing rates of cesarean deliveries are contributing to a rise in placenta accreta cases. Scarring from previous surgeries can provide a pathway for abnormal placental growth, making early diagnosis and monitoring essential.
My Personal Experience with Placenta Accreta
I had a hysterectomy in order to save my life. I went from wanting to experience a natural birth to losing my uterus all in a single pregnancy. Without modern medicine, I would have lost my life. In order to understand how this diagnosis could have come about. You need to know all the uterine trauma I’ve experienced.
My first pregnancy was aborted. I was 22 and naive and had no support from the father. At 5 weeks, I gave up my first baby to God. I will forever regret that. My second pregnancy was vaginal. At 26, I gave birth to a baby boy, Ethin. He was my light.
At 32, I had my second baby boy at 35 weeks to emergency c section. I was alone in the operating room. I had just met my future husband, we were friends. He took me to the hospital and was the first one to take a picture of our son, Wesley, who he later adopted him.
A year and a half later I gave birth to my 3rd baby boy, Elon. At 39 weeks we went in for an induced vaginal delivery. 18 hours of labor and max Pitocin, he wasn’t coming. We had a c section.
3 boys. I always dreamt of having a girl. We waited. Eventually I got pregnant again. Hoping it was a girl we named her Jewel Mae. Unfortunately I had a miscarriage in our kitchen while cooking dinner. I believe I was 10 weeks. I hadn’t even had my first OB appt yet.
A year later we tried again. Success! We found out it was a girl. We were thrilled! This pregnancy has already been difficult being 36 with extreme fatigue. I didn’t know how hard it was going to get.
At 12 weeks my placenta was covering my cervix, I was advised not to have sex to avoid bleeds. I was also started on aspirin daily to prevent pre eclampsia which I had in my prior pregnancy.
With my age of 36 yo, and 2 previous c sections, I was already labeled a high risk pregnancy. Midwives wanted to transfer me to high risk but I requested to stay. I wanted a natural vaginal birth but was talked out of it for safety reasons. Uterine rupture was a major concern. I agreed. Looking back, they should have told me I needed to go to high risk. I didn’t fit the criteria for a natural birth, not even a vaginal birth. I shouldn’t have been cared for by a midwife. But as requested, they continued to care for me.
At 22 weeks I was diagnosed with gestational diabetes and told to check my blood sugar 4 times a day. The placenta still hadn’t moved. I remember my ultrasound tech seeming so unprofessional. She was tall, sandy blonde hair, I even remember her name. She was loud and talked during the entire anatomy scan. Unable to complete in the one hour, 90 mins later she requested help to complete the scan. I could tell she was very new. I was told to come back to complete the scan for eyes and the length of an arm.
I was told I had complete previa when I went to see my midwife and we would monitor it. I had another scan at 32 weeks, still no placenta movement and unable to measure parts of the baby. I had the same tech who was a little faster but still talked and made me uncomfortable. I was upset that she couldn’t do her job and I had to keep coming back.
My midwife asked me if I thought my placenta had moved. I remember thinking how on earth would I know? They reminded me not to put anything in my vagina and sent me home. Each visit was this way. My gestational diabetes was controlled by diet and the possibility of preeclampsia again was controlled by taking aspirin and checking my blood pressure daily. Not once did I ever have a bleed even though the placenta was resting over my cervix.
Next scan at 36 weeks. This scan would determine if I needed to have a c section at 37 weeks or I could hold off to have a c section at 39 weeks. Of course we wanted baby to wait as long as possible. I requested a different ultrasound tech because of the issues I had with the previous one being unprofessional. Once again the office was packed and we waited forever to get a tech that was also stressed from so many patients that day. She finished the anatomy and said I was done. “Wait a second! The whole reason I’m here is to determine if my placenta has moved. This appointment determines if I have a c section next week or 3 weeks.” She looked confused. She left the room and came back with the vagina probe to check for my placenta. She did measurements and left. She came back and told me I needed to go to the office lead. I was so scared. My husband and my kids were present. I believe the lady I spoke with was a nurse or the admin, I wasn’t sure. She proceeded to tell me my diagnosis. Placenta accreta. The placenta had embedded in to the uterine wall right above my cervix. It wasn’t clear if it had invaded in to any of my organs. I was in shock. She was astounded that my midwives never mentioned accreta was a possibility with complete previa my entire pregnancy. I began to cry. I asked for an MRI but she said there was no way they could get me scheduled for one before the surgery. They sent us to the hospital triage to get put on a baby monitor and wait for the surgeon to come talk to us.
The first surgeon I talked to explained how serious this was. They couldn’t tell if the placenta had invaded my other organs until they were actually performing the c section. They explained the possibility of losing a lot of blood but they would have blood ready in case I needed a transfusion. When I got up to use the restroom I heard my husband tell the surgeon that I was scared.
I was frightened for my life.
The second surgeon came in who worked for high risk with my midwives. She made me feel a lot better. She said to prepare to have the c section and also be prepared for a hysterectomy. There’s a chance they could save my uterus but to expect that it would be removed.
All thoughts came racing to my head. What if I die? How will my husband take care of a baby and 3 other children? What will happen if my kids grow up without a mother? What if I survive but my baby doesn’t? How will I go on having lost a child? So many fears!! My husband and I were quiet when we returned home. We finally talked about it. He knew I was scared. He was scared too. We spent the entire pregnancy thinking I was mostly healthy besides having gestational diabetes. It never crossed my mind that it could turn severely high risk. Why didn’t my doctors know? Why couldn’t they fit me in for an MRI especially if death was a possibility during surgery.
I wrote my children and my husband a letter in case I didn’t come home from the hospital with them. I prepared our nursery one last time. It was the longest week of my entire pregnancy. I had an awakening. I had to accept that these could be the last days of my life. I reached out to my mom and my dad. They were scared for me also. I was quiet most the week. I spent time with my kids. My husband kept going to work. We just had to wish for the best. That’s what I felt like. I spent a lot of time wondering why Maternal Fetal Medicine didn’t catch it. How did they not know, with all the scans I had? Why didn’t the midwives prepare me?
I joined support groups for placenta accreta. That’s how I gained my knowledge was from other people who experienced it. I also read some horror stories of women who required blood transfusion and other women who stayed awake for the hysterectomy. Google was surely not my friend. Google told me that death was major possibility. I turned to God. I was praying hard. I asked him to take my anxiety. To watch over my family. I prayed for my unborn daughter, my family, my husband. Mostly for a successful surgery so I could stick around to be with my family.
The morning came. My mother in law stayed the night so she could watch our boys. Jesse, my husband, had coffee. I had nothing because I had to fast. We went to labor and delivery at 6 am. Check in was smooth. I can remember how cold the hospital was. I had to wipe down my entire body with antiseptic wipes for surgery. I was gowned, prepped, IV, all of it. By 7 am we were in the operating room. Anxiety had me shivering. I have to admit that I had a wonderful team! They were so supportive. The anesthesiologist coached me through every step. They talked to me to keep me as calm as they could. I received the spinal tap without issues. My lower half was numb. Jesse was by my side the entire time.
Being awake for a surgery is the most bizarre experience. I had gone through 2 prior c sections and I was still terrified. Rightfully so… It felt like eternity but within moments Paisley was born in to the world. I kissed her. Jesse took pictures. The surgeon talked me through the next steps. She said she was going to try and save my uterus. She was removing the placenta. They were unable to detach it without causing hemorrhaging so I was put under for the hysterectomy. As I counted back to fall asleep, I wasn’t scared anymore. All the things I knew could happen. All the horror stories I read over the past week from accreta support groups. I closed my eyes and just knew I was going to wake up. That feeling I had was the first ever I just knew, I gave it to God. I trusted that I was going to wake up.
When I woke up Jesse was crying. Paisley was in the NICU. They wheeled me past her in my bed . She was connected to a CPAP machine, barely 5 lbs. I also had one artery umbilical cord during the pregnancy so that could have been why she was so small. It was the next morning before I was able to see her again and hold her. Jesse went home to be with the boys. I stayed for 4 days. I didn’t want to leave. Fortunately my milk was flowing by 3 days!! She spent another week in the NICU. We went to see her twice a day and take her breast milk. On the day she was supposed to get out, I had postpartum pre eclampsia and was admitted to the hospital for a mag drip. I’ll share my story about that in another post.
Two days later we were finally reunited. We made it. I was so happy to be home. I felt like a different person. I felt reborn. I felt lucky to be alive. I didn’t need any blood during my surgery. They removed the entire uterus and part of my cervix where the placenta had grown in. I was lucky it didn’t grow in to my bladder. Going that long undetected, I was very lucky that it was not worse. Typically pregnancies that have complete previa have bleeds and some are admitted to spend weeks at the hospital before early deliveries at 34 or even 32 weeks. Maybe because we played it safe and abstained from sex. I’ll never know. I just know I’m lucky and I’m happy.
Nearly 1 year later as I write this post, it’s 3:34 in the morning. It’s been a hellish year. Paisley had colic. I suffered postpartum depression, anxiety, and OCD which I’m currently in therapy for. My younger boys grew a lot and learned to be moms little helpers. Paisley is starting to walk. She’s so beautiful. I can not believe the level of cuteness she is. Every pregnancy I wanted a girl, not gonna lie. As crazy as this adventure has been I’m so glad to be alive.
Were growing our small business. My husband is getting promoted at work. We have a family and a home. As hard as it is some days, I wouldn’t want it any other way. I still have my ovaries so I do have hormonal mood swings like a normal menstrual cycle but I don’t bleed.
For other women who this happened to, they may not be able to say the same. For some it was the first baby and now they can’t have any more. I even read for some they lost their child during the surgery or after and now they can’t have any more. Others had to have bladder or intestinal surgery. And what about the women who lives were taken because it went undiagnosed. There needs to be more awareness provided by doctors for patients.
If you’ve been diagnosed with abnormal placentation and need support, please reach out. You can find me on Facebook, Instagram, YouTube, and X: Cloth and Bottle Co. You can also email me at clothandbottleco.com
The Importance of Early Detection
My story underscores why timely and thorough prenatal care is critical, especially for high-risk pregnancies. Healthcare professionals must take time to evaluate symptoms and risk factors seriously rather than rushing patients through appointments.
How Can We Do Better?
- Advocacy: Patients need to advocate for themselves during pregnancy, asking questions and pushing for thorough evaluations.
- Training: Facilities must ensure staff are trained to recognize and manage conditions like placenta accreta.
- Prioritization: Healthcare systems should prioritize patient care over volume, reducing the chances of life-threatening oversights.
Moving Forward
Now, nearly a year into recovery with a beautiful, colicky 9-month-old, I reflect on this experience as both a cautionary tale and a call to action. My hope is that by sharing my story, others facing placenta previa or similar complications will demand the attention and care they deserve.
Conclusion
Placenta accreta is a life-threatening condition that requires early detection and careful management. My experience highlights the cracks in our healthcare system and serves as a reminder to patients and providers alike: slow down, ask questions, and treat every case with the urgency it deserves.
If you or someone you know is pregnant and has risk factors for placenta accreta, don’t hesitate to seek a second opinion or request additional testing. Your life could depend on it.
