PLACENTA ACCRETA - Can anyone shed any light on this?

[MonicaFree]

I'm 20 wks + 1 with second DC. Didn't have a nuchal fold test at my 1st scan (in Edinburgh so not offered it) but two weeks ago my bloods came back with hormone results giving me high risk of Downs. I agreed to an amnio and although the results for Downs have come back clear, the scan done during the amnio seemed to suggest I have placenta accreta. (They didn't actually tell me this at the time, I just found out when I had a bleed on Boxing Day and was admitted to hospital for observation overnight. The consultant asked if I knew why I was booked in for another scan and basically told me it was because I might have to have a hysterectomy with my c-section. )

I've now spoken to my midwife and done a bit of research on accreta and I'm getting quite scared. Actually, I've gone from shock to terror as I realise that the worst thing isn't me not having any more children but me haemorraging to death. Gulp.

Anyone with any experience of accreta? I'd be really grateful to hear it. Thanks.

Bump

I'm afraid I don't know anything about this but wanted to post and say I'm so sorry you going through such worry. It sounds very frightening. Can you get another appointment with the consultant and ask for more information?

Thanks for posting. I've got another appointment next week for the placenta to be scanned again so they can know a bit more. i just feel so shaken up because the happiest placenta accreta stories I can find are of the 'I'm so happy to be alive despite losing my womb and 16 pints of blood'-type of stories. Not really the reassurance I was hoping for!

Oh shit Monica- that sounds awful. Not surprised you are very shaken. So hope that the scan will bring better news. I do think internet research is often very frightening and sometimes not accurate but you must feel so desperate for information. Hope your partner/husband is offering lots of love and support.

Yes, DH is a star. But seemed to have grasped the situation a bit faster than me and is panicking a bit. Also asking me to write down recipes of mine that he likes: 'in case you die and my next wife can't make them'.

Oh great! I hope you share his sense of humour.
Have you told anyone else?

I looked at wikipedia and it says that it doesn't necessarily result in hysterectomy. Really really hope that either they're wrong or that you have a milder version. It must be an advantage for them to be investigating the possiblilty of it antenatally, though. They can have lots and lots of blood on hand in case of haemorrage.

not the same but similiar outcome and maybe a bit more positive! well I didn't lose as much blood and am sat here cuddling a healthy 15wk old ds.

I was diagnosed with low lying placenta at 26wks in july, bleed and 48hrs stay/ told to take it easy as placenta was close to cervix but might move. fast forward to 33 wks and big bleed, hospital admission and that is where I remained with a section booked for 38wks. scan revealed full coverage of cervix so could bleed at anytime. wanted to go home - have 2dds that needed looking after. but they weren't going to let me leave. I had a bleed at 35wks 5days and it didn't stop. section followed. they had several litres of blood on standby in theatre. section went well, although the placenta was anterior so they had to cut through it to get to baby. I lost 2litres but no transfusion required. Recovery was the same as regular cs, discharged 3 days post cs. DS went to scbu for 8days before coming home.

tbh I didn't research when diagnosed and didn't search archives here - was too scared about what I might find. But I know that if I had had that bleed at 35wks at home, am not sure what the outcome might have been. take care and do as the professionals say and enjoy the rest of your pregnancy.

well a quick google later... lol
it's the least severe of the condition, that is, of the placenta attaching too deeply. there are more severe versions of it.
so that's GOOD!

also, 5-10% of people with placenta praevia have it. i don';t know why but that would placate me a bit, i suppose cos you don't hear of women usually having a hysterectomy after PP do you??? or maybe you do

the other thing that struck me is that you are at risk of haemmorhaging due to manual attempts at detaching the placenta.
this makes me think that there could be a lot of cases where this is undiagnosed until after delivery, and that haemmorhaging occurs usually with these patients ebcause the midwives/doctors aren't aware of the risk they are taking.
does that make sense?

it's good if this is picked up in advance because you will get the appropriate treatment during and after your labour which will inevitably reduce risks

the wikipedia page is really very good actually

I've told my in-laws but my mum's not very well so am holding off telling my family, but this is probably a good thing as they don't live nearby so couldn't help with anything except worrying on my behalf. And my in-laws are all lovely and supportive which is great.

I've checked the wikipedia entry and you're right about the not nec having a hysterectomy (thanks for looking that up). I am so hoping I have a mild version. From what i can gather, I'm phenomenally lucky to have it diagnosed this early on and as I'm being seen at a teaching hospital I know I have really superb consultants looking after me. And from some Aussie study I just found (yes, I know, I must stop my amateur internet medical swotting) it looks as though I have a 1 in 10 chance of avoiding a hysterectomy. This time last week that statistic would have sounded very dark, but the same study was delighted to report 'no deaths' from its sample of women. So that's good then!

Oh Monica, i think the fact that it's been picked up antenatally means that it is v v v v v v v v v v v v v v unlikely that you will die, Honestly. The c-section will be extra well planned to take account of all eventalities and you will be well looked after. Glad the in-laws are supportive.

but remembner, these studies and samples of women could have a lot who have had a lot more severe. i mean, in some cases it can go right through the womb and attach to other things.

so, fingers crossed you're plain old placenta accreta. you have a good chance of it, 75-78% of cases

Thanks for all the replies.

Twinklytoes - Your story is scary but reassuring as well. I'd love to know that I was going to get to 35 wks. And of course it's really, really great to hear that your DS is healthy. I've had one bleed and they've said I'm to ring an ambulance if I have another. (Obviously, I am sufficiently terrified to do exactly that.) And they've also warned me that I may have to stay in hospital later in the pregnancy, though, like you, I already have a 21 month who needs me so I'm not that keen to go. Can I ask you if this means you didn't have a hysterectomy? Did they say if this birth affect your fertility in the future?

ThisIsYesterday- I'm telling myself exactly that. Before I knew what I had, and just thought I was on the antenatal ward for observation, there was a girl on the ward who everyone was talking about: her placenta had grown in her bladder. I'm guessing they'd have picked that up on a scan if I had it.

If you have indeed got placenta accreta then it's brilliant that this has been found and so can be managed pro activley.

Hold on to your toes until the scans are complete and you get the consultants view and opinion. They may suggest an MRI btw [totally safe so no worries].

If you have this type of placenta then the world and his wife and the wife's pa will be at your birth, on call for it or stood outside - and these are the things that will keep you safe. The obstetric, anaesthetic, haematology care in this country is bloody brilliant at dealing with this sort of situation [particulary when it has a warning] so be cool till you know more about YOUR situation.

x

omg! that's really sdcary isn't it?
I have to admit that until I read this thread I Had no idea stuff like that could happen.
makes the good old placenta sound like some raging parasite doesn't it???

That's a great positive post, treedelivery. Listen to her, Monica. She sounds like she knows about these things!

Am midwife...

Treedelivery, thanks for your posts - you do sound like you know exactly what you're talking about so I shall listen, and DH is very reassured with your faith in UK medicine. I am grovellingly grateful to 'your kind'!

Bless you. Give it time one of us will say something hopeless sooner or later!

In fairness to the service - it was set up to deal with exactly this kind of thing, hence we are so much better off than those in the developing world. You wil have a safely managed time of it I'm sure. And mumsnet can stalk you all the way if it helps!!

It wasn't designed [talking the 50's here] to be very nice or user friendly sadly, or to encourage a positive birthing experience, hence it struggles to fit and adapt to the modern world. It is trying though - very bloody trying at times!!

monica - my womb is still in tact! haven't discussed fertility but am sure I won't have anymore though - this pg was enough to scare me out of another.

?similar situation myself - 20 week scan has shown placenta praevia and placenta accreata/ c section hysterectomy was discussed. Am not clear whether I have plac. acc or whether it was just mentioned due to placenta anterior and covering cervix and 2 previous c-sections. My consultant did discuss admission in the final weeks of pregnancy and merits of cs hysterectomy vs leaving placenta to come away naturally but this would entail risk of infection and haemorrhage.

I was fairly freaked out but had decided not to worry too much - next scan 2nd feb when I will be about 32 weeks so will know more then.

My dh suggested I could refuse admission (?why would I want to) but I know they don't suggest admission just for entertainment and if I'm going to bleed I would rather be in hospital

Keep us posted

Just seen this. I had placenta percreta last year - the placenta grew through my cervix. I'm the "lost my womb and 16 pints of blood" one.

From all the research I did while sitting around in hospital - basically women in the UK who are diagnosed before the birth, don't die. You will get the top surgeon and all his cronies. I counted the people in the operating theatre with me and gave up at about 25.

They told me I had a 50/50 chance of a hysterectomy. I had an MRI, the results from which turned out to be incorrect. I kept asking for predictions of what would happen, and they didn't know. But they were very well prepared for every eventuality.

They can't tell for certain if you have accreta, but if they think you do they'll go ahead as if you do - top surgeon, blood on standby etc.

From experience, if they want you in hospital there is a good reason, believe them!

Sorry, I can't be terribly upbeat about it because it is pretty grim. I can give you lots of tips on surviving the antenatal ward with small children at home though!

A year on, my baby and I are both fine, and not having a womb is really rather nice.

(Monica Free is SpeccieSeccie)

(And vice versa. Just thought I'd return to my usual posting name - part of my Trying Not To Be in Denial)

When's your scan?