Possible placenta accreta

[Artioo2]

Hi, hoping for some experiences from others who've been through this or similar - at my 20 week scan last week the sonographer mentioned my placenta was over my previous caesarean scars. Had a consultant appointment yesterday, and he explained I was at high risk of placenta accreta, and what that could mean (longer operation during caesarean, possible serious bleeding, possible need for transfusion, potentially a hysterectomy if they can't stop the bleeding), which was very scary. It's not confirmed placenta accreta yet, just a possibility from the position of the placenta if it doesn't move - I have another scan booked at 28 weeks to check again.

Has anyone been high risk for this before, and what was the outcome? Thanks.

Are they doing an MRI to confirm?

As I understand it, they'll do another ultrasound scan and decide on the MRI then.

Placenta accreta usually or often involves an elective section a bit earlier, around 34-36/40 and the use of interventional radiology to reduce bleeding. So putting small catheters in your uterine arteries which are blown up nice baby is born to reduce blood supply to the uterus. It works very well generally. Usually spend a few days on delivery suite HDU. Sometimes a part of the placenta is left inside depending on severity of accreta/percreta.

A lot of units don't routinely deal with this and refer you out to tertiary units

Thank you, the consultant did mention the catheter thing but I couldn't remember the details or the name of it - too panicked about everything else he was saying! Luckily I'm near a large hospital, so they can do it there. I'm most worried about a possible general anesthetic and length of time before I can hold / feed the baby I think.

I can't give any advice but awaiting a fetal medicine scan to confirm/rule out accreta too. I have placenta praevia and the placenta hadn't moved at 28 or 32 week scan. I am nervous as hysterectomy was mentioned to me my appointment is on 25th which seems like an age away. I haven't had the opportunity to chat to a consultant yet - I have only seen a monographer up until now and would have appreciated a chat just to ask a few questions. So hand holding to you from me.

I had placenta accreta with percreta into my bladder with ds (dc3) after 2 previous cs. delivered by elcs at 34+5 weeks. I had a partial hysterectomy (still got ovaries), bladder surgery and 7 litre blood transfusion. I breastfed ds who is now a strapping 2 year old, he did not need SCBU or NICU. I had a catheter for 2 weeks and a 12 week recovery.

Ask away if you have any questions I can answer I will.

They usually do the CS under epidural. Often put it and then go to radiology and then for CS. It's a very high risk situation with potential complications but it will be good once and if its diagnosed as they will be able to provide you with the best care possible and everything will be in place for you

I have had accreta twice with ds1 (2nd pg) and ds2 (4th pg)
Lost a lot of blood with ds1 as placenta was over previous scar and with ds2 the area of accreta was higher up and didn't involve scar so that was dealt with easier.

I had an mri and u/s scans with both. Extra Iv access and arterial lines put in before caesarean too and interventional radiology on standby

Felt quite unwell after ds1 but I think due to the blood loss. It is a scary prospect but you should be offered an mri to confirm then a plan will be made when to do cs etc etc

Thanks for the replies everyone.

Wombat79, it's horrible waiting isn't it. I've got 6 weeks to wait for another scan to seek if anything has changed, it seems like forever.

Thanks for the info Mummyme. The consultant did talk about having a team on standby so I keep reminding myself it's better they're prepared for it beforehand.

AnotherStitchInTime, that's great to hear you successfully breastfed, that's what I'm most worried about I think. If you don't mind me asking, were you under general anesthetic? How soon were you able to feed your DS after the birth? Did you have any issues with your milk coming in?

Teenagecrisisagain, thanks for your story, it's good to hear you've come through it twice ok.

The first time was a little worrying but the second time it was dealt with and I had no blood loss issue etc at all.

I think the key is getting a definitive diagnosis and having a team there in the day so that they can deal with any eventuality

Good luck!

Sorry not to respond sooner artioo.

I had epidural for ds birth and he was placed on me for a while, then given to DH for a bottle. At this point I asked to be put under general for the hysterectomy. Ds had 2 bottles from DH. I requested skin to skin as soon as I was able and ds fed then. It was about 7-8 hours after he was born I think. I was in surgery for 5 hours, so fed him about 2 hours after I came out of theatre. My colostrum was already in before his birth and my milk came in fully by day 5, later than with the first two.

I should stress that my case was the most extreme kind of accreta where it grows into and out the other side of the uterine wall. This is much less common. I had an mri and a colour doppler that both showed high likelihood of percreta before surgery so I knew that hysterectomy was likely and could prepare.

Thanks AnotherStitchInTime. Wow, 5 hours in surgery! Great to hear you did breastfeed after this. Would they have done the op with just an epidural if you hadn't asked for a general anesthetic?

No they wanted to put me under as soon as he was born, but I stalled so I could see more of ds.

Just wanted to update this thread in case anyone else is searching for similar stories in future - had another scan today at 29 weeks, and the placenta has 'moved' away from my scars, so they've ruled out a risk of placenta accreta.

Brilliant Artioo, all the best for your upcoming delivery x