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Second opinuion for PP Accreta?

(6 Posts)
Smooches Wed 05-Dec-12 11:32:03

Hi all, has anyone had any experience of this? My consultant wishes to just leave the placenta rather than take it out when I go for my c-section in a couple of weeks but Im not so sure about this. I have had an MRI twice, Doppler scan also and they seem to think the placenta has grown right through to my bladder which will require surgery if they take the placenta out.
Can anyone advise on a good obstritic dr I could get a second opinion with please or if anyone else had been in the same position can advise? I have not long really before I go for my op so fearing I may have left it too late.

Smooches Wed 05-Dec-12 13:48:15


SlouchingPanda Wed 05-Dec-12 17:37:34

Has your obstetrician explained to you what the alternatives are, and what the risks of each option are? Have you asked about their previous experience with this? Where abouts in the country are you?

If you have a true accreta the placenta will not separate - s/he will be unable to remove it, so the choices are fairly limited.

Smooches Wed 05-Dec-12 19:01:37

Yes she has explained the alternatives such as hysterectomy but she feels that leaving the placenta in would be a better option to minimise blood loss. To me this is wrong seeing as there are so many woman who have bits of their placenta left in when they have given birth and go on to have have D n C's how can it be medically feesable to do this? It just seems wrong and a way of saving money? In saying that in the long run surely it will cost a hell of a lot more to just leave it and then have to go back into surgery?
I have recently move to Surrey BTW

runawaysimba Wed 05-Dec-12 19:13:41

I'm not in the UK so can't help with recommendations, but I had placenta accreta so I sympathise - it's a worrying thing to have to deal with, so I'm sorry you've had this news. The way it was explained to me was that it's very hard, even with MRI, to judge how extensive the accreta is, so they made a decision on how to deal with it when they could actually see it at my section. In my case, it was so extensive and the bleeding so bad they had to remove that part of my uterus, but they told me beforehand that leaving it may actually be an option, because it may then separate itself, at which point it could be removed/delivered. In other words, it's a way of possibly saving you from having a hysterectomy. Of course, every case is different, but their saying they would try to leave it seems positive to me, if it means there's a chance to save the uterus.
Best wishes with the rest of your pregnancy!

SlouchingPanda Wed 05-Dec-12 21:31:27

You may find the following to be interesting reading (taken from the Royal College of Obstetricians and Gynaecologists guideline on managing placenta accreta - you can find it via google if you want to read the whole thing but it's quite heavy going and aimed at a medical audience):

The diagnosis of placenta accreta is made only if the placenta fails to separate at delivery; therefore, if it comes away it is delivered as usual. If, however, it partially separates and ‘partial accreta’ exists, the associated blood loss can be large.Adherent portions should be left attached as trying to separate them can cause severe bleeding. In the case review mentioned above, 25 of the 60 cases had partial placental separation; three of these women needed hysterectomy for failed conservative treatment, and 12 others had secondary procedures to evacuate the uterus, which was conserved.

So basically of 25 women with bits of their placenta accreta left in, 3 went on to need a hysterectomy later down the line, 12 had other surgery to stop bleeding but kept their womb, and in 10 this approach was successful with no further intervention needed.

It sounds like your obstetrician is following advice from their professional body and trying their best to ensure that you don't automatically end up with a hysterectomy, but it is their job to explain it all to you so that you are happy with the plan. If you are meeting them again before the op, maybe ask questions about what their planned follow-up will be and how they will monitor you for complications such as bleeding and infection.

If it a really difficult one as there is no simple and easy answer and all options are tied up with potential risks. Good luck with it all, and I hope that despite what must be a worrying and anxious time you still find joy in your imminent new arrival!

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