Placenta accreta is a serious but rare pregnancy complication. It can cause harmful bleeding.

If you have placenta accreta, you will need special care when you have your baby.

What is placenta accreta?

Placenta accreta develops when the placenta implants too deeply into the wall of the uterus (womb). Sometimes it can grow through the muscle wall and outside the uterus.

After the birth, the placenta doesn’t come away as normal. It stays firmly attached to the uterus. This can cause severe bleeding and can be life threatening.

Placenta accreta can also cause premature birth.

How is placenta accreta diagnosed?

The condition may be picked up by your doctor during your pregnancy through antenatal ultrasound. But in other cases, it may not be found until the baby is born.

If a diagnosis is made antenatally, your doctor will discuss a caesarean birth and the risks.

Complications are more likely if placenta accreta is found at delivery.

It’s important to attend your routine antennal appointments throughout pregnancy. Often complications can be identified during these appointments.

What is the cause of placenta accreta?

Although placenta accreta is rare, it has become more common in recent years. The chance of having placenta accreta increases with the number of caesareans you have.

Any surgery that leaves scarring on the lining of the uterus can raise your chances of developing placenta accreta.

The risk also increases if:

• you have had fibroids
• you are having twins
• you have placenta praevia
• you are a smoker
• you are older than 35

What are the symptoms of placenta accreta?

Often placenta accreta doesn’t cause any symptoms during pregnancy. The most likely symptom is bleeding in the third trimester.

Placenta accreta causes severe blood loss after delivery.

If you have any vaginal bleeding during pregnancy, see your doctor. If the bleeding and pain is bad, call triple zero (000) for an ambulance. Or go to your nearest hospital emergency department.

CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.

What are the risks to you and your baby?

Placenta accreta can be life threatening. It causes severe blood loss after delivery. It can prevent blood from clotting and lead to lung and kidney failure.

Placenta accreta can cause bleeding and your baby may need to be delivered early (prematurely).

How is placenta accreta treated?

If your doctor suspects you have placenta accreta during your pregnancy, they may order:

• a vaginal ultrasound
• an MRI

They will monitor you and your baby. They will also arrange for you to give birth in a major hospital with the appropriate medical support. You will need to stay close to the hospital during your third trimester.

You will need to have a caesarean. Your obstetrician will probably suggest that this happens before your due date to avoid you going into labour early.

Your obstetrician will discuss the safest treatment options with you before the surgery. They will try to avoid major blood loss and infection. Your options may include a blood transfusion and hysterectomy (removal of your uterus).

If you wish to have more children, your obstetrician may consider leaving the placenta inside the uterus. This will depend on your individual circumstances.

Although this means avoiding a hysterectomy, it can increase the risk of postpartum haemorrhage and developing a serious infection.

You will need to have many check-ups and tests in the months after having your baby. There is a high chance of needing a hysterectomy later if there are complications.

FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.

Recovering from placenta accreta

You will need to spend some time in hospital to recover from the surgery. You will still be able to cuddle and bond with your newborn baby.

It’s common for women who go through birth trauma to feel many emotions. These might include:

• sadness
• shock
• anger
• disappointment
• anxiety
• depression

It’s important you speak with your medical team so they can help you and your family through your recovery.

You can also get help and support from:

• Pregnancy, Birth and Baby — call 1800 882 436 to speak with a maternal child health nurse. They are available 7 days a week, from 7am to midnight Australian Eastern Time.
• The Australian Birth Trauma Association offers advice, resources, and a peer support service.
• The Centre of Perinatal Excellence (COPE) provides information and a list of support services.
• Perinatal Anxiety & Depression Australia (PANDA) — call 1300 726 306 to speak with a counsellor. They are available from Monday to Friday from 9am to 7.30pm Australian Eastern Time.