placenta accreta?? but no mri scan?

[ariane5]

I am 34 wks with dc 4 (3 prev c/s)

With second pg i had placenta accreta (confirmed by mri) lost a lot of blood during delivery but they knew where the placenta had grown through so could cut in right place to avoid cutting right through it and making bleeding even worse.
3rd pg placenta posterior so no problems.However with this pg it is anterior, had ultrasound today but they couldnt see my scar and could not say either way if placenta was over the scar or not, the sonographer said only an mri would show this.
When i saw the doctor he said no to mri and just said that on the day of my caesarean they will have some blood ready just in case and if things started going wrong theres always a senior surgeon around and they would then give me a general.
Surely they should do an mri to know for definate what they are dealing with like they did with my 2nd pg?? how can they just go in blind not knowing if they are going to cut through the placenta or if i have accreta again?

Should i go back and insist on an mri ? Iam petrified especially after last time that it will be the same situation but i do not know what to do. My caesarean is booked for 4 weeks time.

bump

I'm sorry I don't know what placenta accreta is so can't offer help. But you are always entitled to ask for a second opinion if you dont agree.

thankyou blueandred i think i will def have to go for a second opinion.

Placenta accreta is where the placenta grows into the deeper layers of the uterus and sometimes through it (with dc2 it grew through my scar), it makes the placenta very difficult to remove can cause bleeding etc

Hi I would insist on an MRI and depending on the results of that move forward to a plan for delivery.
I work in an obstetric setting and sometimes women with this problem need extra specialists in theatre including radiologists.
I would be a bit cautious of your drs rather cavalier attitude actually.
Are you booked in a large teaching hospital?

No am booked into a local hosp (was on special measures a few years ago and most people in this area tend to avoid it and opt for different hosp-i have no option as dont drive and its the nearest).

Phoned today again but they will not see me and are adopting the wait and see what happens on the day attitude that fills me with dread especially as ive had this before and lost a lot of blood (and that was when they knew and HAD done an mri)

I am getting very fed up and quite frightened, i just want to know either way but they do not seem concerned at all.

www.rcog.org.uk/files/rcog-corp/GTG27PlacentaPraeviaJanuary2011.pdf

This guideline is what most drs should be working to and has some information on using MRI to diagnose placenta accreta - it seems to say that is it debabteable whether MRI is of any value - some think yes some know. Maybe have a little read and it may reassure that is is not necessary or give you some more information to argue your case? Good luck.

thankyou i will def have a read, I think because when i had this before the drs were so adamant i needed mri and this time they wont do anything even though ultrasound was inconclusive. My fear is that they will be going in blind and could cut through the placenta and that they wont even know if it is accreta again. I feel very dismissed by the hospital and they do not seem worried at all. Maybe iam being panicky and over cautious but it was such a horrible experience before and really scary.

Ariene I would book at the other hospital tbh how far away is it?
You will be having a planned cs so travelling on the day could be planned, if you are worried about cost talk to patient benefits people at the hospital.
If you really don't want to change your booking make an appointment to see your consultant and take some one with you and have a full discussion re all your worries.
If you have no luck there I would possibly go back to your gp spell out what has been discussed so far and ask their advice, ask what they would do if they or their loved one was in this position.

Just remembered many hospitals have volunteer drivers to take patients to appointments, you could enquire about that too :)

Enquired today and the next nearest hosp are not taking anybody who is out of borough now.tried to get appt at my hosp but they will not give me one till 20 april and my cs is planned for the 24 so too late.

I cant seem to get through to them how important it is so have appt to see private hosp and possibly will pay for an mri (hideously expensive but my only option i think )to get it done and either put my mind at rest or a problem confirmed that i can then make a plan for.

Really really shocked at the hosp attitude to this, hopefully everything will be ok but they really do not seem to care at all that potentially there could be a huge problem.I know how serious it can be as have been through it before and it was not nice, id at least have thought given my history they would be more careful.

Ariene5 I am sorry to hear that you don't have a choice about where you deliver.
I would write a letter to your consultant asking again for an MRI scan prior to your cs, I would also ask whether interventional radiologists will be available on site on the day you deliver.
I would express your fears that you could have a placenta that is not deliverable if it has infiltrated other areas apart from the uterus.
I would copy this letter to the medical director, consultant midwife, consultant anaesthetist.

well I had my mri yesterday and got the results today. The placenta is not covering the previous cs scars but i do have accreta.

Really quite upset, now I have to try and get an appt to see the hospital and try to see how they will manage it, do not really fancy my chances seeing as they refused the mri in first place and were so dismissive of my concerns.