Placenta Accreta.....should I risk 3rd pregnancy?

[lumpasmelly]

Dorry this is so long, but need to give the background - Had a lovely birth with DS2, but it all turned into a bit of a disaster as i was rushed to theatre with a retained placenta which needed to be manually removed under spinal block. At the time, I wasn't too concerned because I was so happy to have delivered my son safely and that it had been such a positive experience...however, my husband tells me that I was in surgery for almost 3 hours and that everyone looked very concerned. The following day, I was told my bloodcount was down to 7.2, and that I needed a blood transfusion - no-one had mentioned PPH, so i am not sure if this is normal after a manual removal. Anyway, after a slow recovery (having refused the blood transfusion) I didn't think anything more of it, and thought that it was just one of those things, and that retained placentas are quite common. however, I did notice in my notes that the hospital had written down that I had had placenta accreta. I asked my GP about this and she didn't know what it was, and as I had private health care, she suggested i go and see my gynacologist. He decided to give me an ultrasound to make sure all the placenta was gone and as it turned out, there were still bits of placenta left in my uterus which he then removed with a D&C. Following this procedure i made a complete recovery, but my consultant was very bleak about the possibility of the accreta happening again. He said that as it happened once, there was an increased probability of it happening again, and that if it did happen again, I might not be so lucky, and that i would probably have a massive haemorrage which would lead to hysterectomy or possibly death. I was a bit taken aback, especially as the hospital and the midwives had all discharged me without a mention of this sort of risk...if I hadn't mentioned this to my doctor, and gone for a private follow up, I would be none the wiser. So here i am, 10 months later, looking at my 2 lovely little boys and thinking "just one more....", but after what the consultant told me, I am totally torn. I would love another baby, but if my gynacologist is right, then I could be putting my life at risk...but then on the other hand, if this was really the case, surely the hospital would have said something when they discharged me? Does anyone know anything about this condition, or have any advice? I think i need to get as much info as possible before the broodiness takes over!!! Many thanks in advance!!!

I'm afraid I don't know but I can recommend a fab gynae in London if that's any use and you would like to go and see her for a chat and a second opinion? She really is marvellous.

I would ask your GP to refer you back to the consultant team who were involved in your care when you had the manual removal. Also ask for a copy of your notes / scans from the private gynae to be sent to them first. Then, they will have access to all your medical records and may be able to help you make a decision.

You definately need a second opinion! I would say that if that concurs with your gynae's view that another pregnancy carries a significant risk then you shouldn't go for it. You and your dh could I'm sure cope with the disappointment of not having another child far better than any of your family could cope with your loss or serious illness.
Of course it's easy for me to say that as I am lucky enough to have three children. I had a minor pph with dd3 though - and it did make me think. I doubt I would have wanted another anyway but now I know - the stakes are too high. I feel for you

Surely pregnancy is not the risk it is a birth and if they did a C-section they would be manually removing the plancenta anyway. I would have thought it just makes natural delivery dangerous.

You probably would not choose a c-section but if you would really like another babe does not matter how it arrives just that it does safely!

Thanks for all the advice....I think a 2nd opinion is a good idea, so I will try and get hold of my notes. I suppose I just don't feel i have all the information at the moment, and if i knew for sure that it was highly risky, it would be an easier decision...i can handle a c-section, but not some odds on potential death!! The name of that gynacologist would be fab please!

The Gynae is Katrina Erskine and privately, she works on Harley st (Thursdays I think) and out of the Portland. Tel: 0207 390 8079 (secretary).

She is a very strong and reassuring character who will give you the facts without any wool and without any drama and makes you feel as if you could cope with anything. She is a very positive person and regardless of what she tells you, you will feel completely confident in everything.

Just seen this. I had placenta accreta with my 3rd baby.

2 months on the antenatal ward, emergency cs at 33 weeks, 16 pint blood transfusion, hysterectomy, 12-hour GA, woke up in intensive care. 10-inch vertical scar. Not fun.

Its not just about the birth! But I did have placenta previa as well.

You need to ask what the odds are, and how they would treat it if you did have it.

If you want to google, the other name is "morbidly adherent placenta".

Have you had any operations on your uterus such as a caesarian or hysterotomy? If you have then the risk is going to be greater IF the placenta is over the original scar (and obviously you have no control over where the placenta implants). Your hb going to 7.2 is not great, but it is not life threatening. I think that sometimes people say things (ie your gynae) without really thinking about what it would mean to you not to have another baby. It wouldn't stop me from doing it.

Oh also CharlotteYork, having a cs in this case would actually increase the risk of bleeding a lot, not decrease it.

Hi, I know this is an old post but I have been searching for advice on exactly the same issue and was wondering what you chose to do in the end? The birth of my second child sounded exactly like yours, with manual removal of a placenta which was completely stuck. The recovery was awful and I felt ill for a long time afterwards.

I had always intended having 3 kids but now I'm not sure I want to put myself at any risk to have a third. However the desire to have a third is undeniably there.

I would be interested to hear from you.

After DC1 I had some retained bits of placenta which needed removing under spinal block. This was only spotted several days after giving birth so I lost a lot of blood over a long period and my HB was 6 and I needed
a transfusion.

Was very worried about same thing happening with DC2 but it was fine.

That said I was never told it was placenta accreta which is presumably more problematic than 'just' a retained placenta? So I would definitely talk to a recommended gynae.

I actually had unrelated (but very severe) health problems after DC2 and had similar fears over whether I should go ahead with a 3rd pregnancy. Anyway, I talked to my GP who said that I'd just had freakish bad luck and to go for it, so am due in a few weeks now and hopefully all will be ok!

Good luck.

Hi - I'm the OP and just seen this revived. I decided to seek a second opinion and got my operative notes dredged up by the hospital and went to see the head of obstetrics for some advice. She told me that there is no way of telling if it actually was accreta, but seeing as I didn't end up in worse shape(i.e. like one of the other posters on this thread in intensive care) it was unlikely - she recommended that I should have another baby if I wanted one. So now I am 27 weeks pregnant with DC3, and I am also seeing that same obstetrician privately (as I don't want to take ANY chances).

Some placental "lakes" were noted on my placenta at my 20 week scan (which can be an indication of accreta)but nothing else suspicious was noted - however my babies growth is being monitored by scan starting from 28 weeks to ensure that the placenta is functioning normally (as DS2 was almost 3 pound lighter than his brother, which is an indicator of a placenta that isn't quite right). Also, my placenta is in the same location as it was before, so the chances of it being tricky to remove have increased, as this is the area of previous scarring (likely to have been caused by a D&C following a missed miscarriage). In terms of delivery, I am having an elective c-section this time as my obstetrician thinks that it will be safer - it there ARE any problems, then they will already be inside me to sort them out, and they can be prepared. She is still very positive that this isn't going to be the case, but is happy to perform the CS anyway on the grounds that (a) I also have quite bad SPD, (b) my last 2 babies have been back to back and because of my body shaped it is likely to be the same again this time so we aren't looking at a fast epidural free birth and (c)she doesn't want me stressing about my placenta during labour, which inevitably I will. So, fingers crossed it all goes well and there are not issues with the placenta, but at least I know now that IF there are, there are plenty of contingency plans in place to ensure that I don't come to any harm. From what I gather, Accreta is only really dangerous if undetected and the right people/equipment aren't to hand when you give birth.

I haven't read all your OP as I can't see properly atm but I had a retained placenta with DC2. DC1 had been born by emergency section without me going in to labour. DC2 I had naturally, DC3 I had naturally but was given the injection to have ther placenta delivered without my express permission and the birth was highly risky. We are not having any more but that is because of the problems after the section, not because of the retained placenta.

Lumpasmelly - I too had placenta accreta with 2nd and was advised not to have more. So very interested to hear about your outcome with no. 3. My obstetrician said it wld happen again, all doom and gloom about emergency hysterectomies etc. we therefore decided against, but wld love more...
If you do read this, please let me know what happened. And indeed anyone else having babies after a placenta accreta diagnosis!
Thanks!

ARE YOU COMPLETELY INSANE???

Ok, so I know this is an insanely old post! But how did you get on with the birth?! I had accreta with my little boy but am really starting to think about having another baby and I was curious to know how you got on with your delivery?

@lumpasmelly

Dorry this is so long, but need to give the background - Had a lovely birth with DS2, but it all turned into a bit of a disaster as i was rushed to theatre with a retained placenta which needed to be manually removed under spinal block. At the time, I wasn't too concerned because I was so happy to have delivered my son safely and that it had been such a positive experience...however, my husband tells me that I was in surgery for almost 3 hours and that everyone looked very concerned. The following day, I was told my bloodcount was down to 7.2, and that I needed a blood transfusion - no-one had mentioned PPH, so i am not sure if this is normal after a manual removal. Anyway, after a slow recovery (having refused the blood transfusion) I didn't think anything more of it, and thought that it was just one of those things, and that retained placentas are quite common. however, I did notice in my notes that the hospital had written down that I had had placenta accreta. I asked my GP about this and she didn't know what it was, and as I had private health care, she suggested i go and see my gynacologist. He decided to give me an ultrasound to make sure all the placenta was gone and as it turned out, there were still bits of placenta left in my uterus which he then removed with a D&C. Following this procedure i made a complete recovery, but my consultant was very bleak about the possibility of the accreta happening again. He said that as it happened once, there was an increased probability of it happening again, and that if it did happen again, I might not be so lucky, and that i would probably have a massive haemorrage which would lead to hysterectomy or possibly death. I was a bit taken aback, especially as the hospital and the midwives had all discharged me without a mention of this sort of risk...if I hadn't mentioned this to my doctor, and gone for a private follow up, I would be none the wiser. So here i am, 10 months later, looking at my 2 lovely little boys and thinking "just one more....", but after what the consultant told me, I am totally torn. I would love another baby, but if my gynacologist is right, then I could be putting my life at risk...but then on the other hand, if this was really the case, surely the hospital would have said something when they discharged me? Does anyone know anything about this condition, or have any advice? I think i need to get as much info as possible before the broodiness takes over!!! Many thanks in advance!!!

First, congrats on your healthy boys! Not sure where you live, but I strong suggest you email Professor Sally Collins at John Radcliffe Hospital in Oxford. She's a leading accreta specialist and will be able to give you some good advice. You should be able to find her email address online x

Prof Collins is amazing and lovely, but OP is from 2008 so I suspect she might have made a decision one way or another!

@SockQueen

Prof Collins is amazing and lovely, but OP is from 2008 so I suspect she might have made a decision one way or another!

Well spotted! 🤦🏻‍♀️😂

From what I gather, Accreta is only really dangerous if undetected and the right people/equipment aren't to hand when you give birth

well you gather wrong. accreta is EXTREMELY dangerous and unpredictable. I know this is an old thread but in case someone else in your situation is reading it