Rates of Placenta Accreta Continue To Rise, Increasing Childbirth Risks

Placenta accreta can dramatically increase the chances a woman will experience serious complications during childbirth, including the risk of severe, life-threatening bleeding. This condition was once extremely rare, affecting around one in 4,000 U.S. pregnancies every year. Now, it is increasingly common, threatening the health of thousands of expectant mothers each year.

A mother’s prenatal care providers and OB/GYN must screen for and diagnose this condition, then take appropriate steps to mitigate the risks for both the mother and the baby. Placenta accretion can lead to fatal hemorrhage if a labor and delivery team isn’t prepared or equipped to handle it.

What Is Placenta Accreta?

The placenta is a temporary organ that develops along the wall of the uterus during pregnancy. Blood flows from the placenta to the growing fetus through the umbilical cord, transferring oxygen and nutrients and removing waste products. Shortly after the child is born, the placenta detaches from the uterine wall and is delivered from the mother’s body. (This is also called the “afterbirth.”)

In a patient with placenta accreta, the placenta grows too deeply into the uterine wall. Instead of cleanly detaching and severing the flow of blood from the mother, part or all of the placenta can remain entrenched in the uterine tissues. This often leads to hemorrhage and severe blood loss.

Placenta accreta is only one of many potential problems that can affect the placenta during pregnancy. Other implantation issues, such as placenta increta (where the placenta grows into the uterine muscles) and placenta percreta (where it grows through the uterine wall), can be extremely dangerous. Influencer Chrissy Teigen recently raised awareness about placental abruption, a condition in which the placenta separates from the uterus before labor.

While all these conditions can cause serious problems for both the mother and the developing child, proper prenatal care can significantly reduce the risk of adverse effects from placenta accreta. As the rates of this condition increase, it’s more important than ever for providers to identify patients with higher risk factors and take appropriate steps to prevent harm.

The Impact of Increased Rates of C-Sections

Patients who have previously undergone a cesarean section (C-section) or other uterine surgical procedure have a greater risk of developing placenta accreta. This is due to the scar tissue that forms along the walls of the uterus after surgery. If the placenta grows into this scar tissue, it can become embedded more deeply and have greater difficulty detaching cleanly. 

The increasing frequency of cesarean deliveries in the U.S. is likely a significant factor in the growing occurrence of placenta accreta. However, some of the rise in reported cases can be attributed to increased awareness of the condition and improved ultrasound screening technologies. As the rate of placenta accreta continues to grow, health departments and medical organizations are sounding the alarm. Prenatal identification of the condition enables families and their care teams to take action to reduce their risk.

The most significant factors that increase a mother’s risk of placenta accreta are advanced maternal age, prior cesarean deliveries, and abnormal placental positioning. Often, there are no signs or symptoms of the condition, although sometimes it causes vaginal bleeding during the third trimester. Instead, it is usually detected during a routine ultrasound.

Managing Placenta Accreta During Childbirth

The increase in placenta accreta cases across the U.S. is a factor in the rising rates of maternal mortality. Unfortunately, many patients have limited options. Patients with placenta accreta should deliver by approximately 35 weeks to minimize their chances of severe bleeding. If the condition is diagnosed during pregnancy, doctors will often schedule a C-section delivery. Performing a hysterectomy, or removing the uterus, may be necessary if doctors cannot cleanly remove the placenta.

Even when doctors schedule and plan a C-section, the chance of hemorrhage is high. Patients with this condition should plan a delivery in a hospital facility that has specialized knowledge, equipment, resources, and personnel. They will need an experienced obstetric team, including an obstetric surgeon. Other specialists, such as urologists, general surgeons, and gynecologic oncologists, should be available if necessary. Their care team should plan to ensure blood supplies are available.

Besides causing massive blood loss, heavy bleeding caused by placenta accreta can also 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. Problems or delays in appropriately treating patients with placenta accreta can lead to preventable maternal deaths during and after delivery.

Many facilities cannot provide the level of skill and support necessary to mitigate the risks associated with placenta accreta. Providers should discuss the risks with their patients and consider referring high-risk patients to facilities that specialize in these deliveries. Failing to recognize the condition and advise patients of the severity of these potential injuries may constitute malpractice.

Have You Been the Victim of Medical Malpractice?

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 child. Patients and their families may be able to pursue actions for wrongful death or other injuries related 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, P.C. to schedule a free, no-obligation, confidential consultation.