BY: Richard L. Groffsky | IN: Birth Injury, Medical Malpractice
Pregnancy and childbirth have a wide variety of risks and potential complications, which is why skilled prenatal and obstetric care is essential. One of the possible dangerous conditions that can occur during pregnancy is placenta accreta. If undetected or treated incorrectly, this condition can lead to premature labor and/or severe vaginal hemorrhaging during and after delivery. It’s important for your OB/GYN providers to ensure that this condition is properly diagnosed and treated to avoid life-threatening delivery outcomes.
During pregnancy, the placenta develops in the uterus to provide oxygen and nutrients to your growing baby and remove waste products from your child’s blood. The placenta attaches to the wall of your uterus, and your baby is connected to it by the umbilical cord. Normally, the placenta detaches from the uterine wall after childbirth and is delivered out of the body. Placenta accreta occurs when blood vessels and other parts of the placenta grow too deeply into the uterine wall; following childbirth, part or all of the placenta remains firmly attached. This can cause severe blood loss. Other related conditions include placenta increta (where the placenta grows into the muscles of the uterus) or placenta percreta (where it grows through the uterine wall).
Women who have placenta accreta may not notice any signs or symptoms during their pregnancies, although sometimes it causes vaginal bleeding during the third trimester. The condition is often detected during a routine ultrasound.
In a twenty-year study published in 2005, the overall incidence of placenta accreta was 1 in 533 pregnancies. The researchers noted that the most significant risk factors were advancing maternal age, two or more prior cesarean deliveries (C-sections), and previa (where the positioning of the placenta is unusually low in the uterus, next to or covering the cervix). The American College of Obstetricians and Gynecologists notes that the rate of this condition is increasing, possibly due to increasing rates of cesarean deliveries.
Besides being inherently dangerous by causing massive blood loss, the heavy bleeding after childbirth that placenta accreta causes can lead to a life-threatening condition that prevents a mother’s blood from clotting normally (disseminated intravascular coagulopathy), lung failure (adult respiratory distress syndrome), and kidney failure. Blood transfusions are often necessary. Because the rate of maternal mortality in patients with this condition has been reported to be as high as 7 percent, accepted medical practices warrant that a mother with placenta accreta should deliver by approximately 35 weeks to prevent severe bleeding
Placenta accreta is considered a high-risk pregnancy complication. Grayscale ultrasound technology is typically used to diagnose or rule out placenta accreta during the third trimester of pregnancy. If this condition is diagnosed or suspected during pregnancy, a scheduled C-section delivery followed by surgical removal of the uterus (hysterectomy) is a commonly recommended treatment. The ACOG recommends that, for women who are known or suspected to have this condition:
Delivery planning may involve an anesthesiologist, obstetrician, pelvic surgeon such as a gynecologic oncologist, intensivist, maternal–fetal medicine specialist, neonatologist, urologist, hematologist, and interventional radiologist to optimize the patient’s outcome To enhance patient safety, it is important that the delivery be performed by an experienced obstetric team that includes an obstetric surgeon, with other surgical specialists, such as urologists, general surgeons, and gynecologic oncologists, available if necessary. Because of the risk of massive blood loss, attention should be paid to maternal hemoglobin levels in advance of surgery, if possible. Many patients with placenta accreta require emergency preterm delivery because of the sudden onset of massive hemorrhage. Autologous blood salvage devices have proved safe, and the use of these devices may be a valuable adjunct during the surgery.
Improper management of high-risk pregnancy conditions like placenta accreta can result in trauma, injury, and other serious harm to a mother and her newborn infant. Juries have awarded significant compensation to victims for wrongful death and other injuries due to placenta accreta. If you have concerns about the medical care you received during your pregnancy, labor, and delivery and suspect you may be the victim of medical malpractice or negligence, please contact the experienced birth injury attorneys at Sommers Schwartz.
View all posts byRichard L. Groffsky
Richard Groffsky focuses his practice on medical malpractice and personal injury litigation, and has represented victims of devastating brain injuries and birth injuries in Michigan, Ohio, Illinois, Indiana, South Carolina, and Georgia in significant brain injury and birth injury cases.