Avera Medical Minute: Diagnosing Placenta Accreta in pregnant women

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Pregnancy can be an exciting and happy time for expecting mothers, but it can also carry a lot of unexpected complications.

One of those is a condition known as placenta accreta, which carries significant risks for both mom and baby.

Katie Ibarra and her husband knew they wanted a third child.

“I was excited to be pregnant again,” Ibarra said.

When Katie went in for her 20 week scan, doctors noticed something that wasn't right. By 28 weeks, their fears were confirmed.

Katie was diagnosed with a form of placenta accreta, known as placenta increta which invades the muscle.

“I was a little bit nervous and of course I googled it and I should not have googled it because that was very scary,” Ibarra said.

“About one in 275 women are going to be facing this condition,” Avera Adult fetal medicine specialist Dr. Oscar Viteri said. “We noticed that the placenta was implanted low.”

During a normal pregnancy, the placenta exchanges nutrients and oxygen between mom and baby.

Normally it attaches to the uterine wall and after the baby is born it comes out automatically.

But, if there is a prior scar, like from a C-section, the placenta can invade the wall and beyond.

This is known as placenta accreta.

“This is heartbreaking news that we have to deal with moms because this can be a very life threatening condition,” Viteri said. “When the placenta is invading and those blood vessels kind of go inside the womb, there’s always a concern that there may be a lot of bleeding at the time of delivery.”

If it goes undiagnosed….

“The unsuspected provider may try to deliver the placenta and if they rip, those blood vessels rip, there’s a potential for massive hemorrhage,” Viteri said.

Unfortunately, the only way to treat placenta accreta comes at a price for moms.

To prevent a large amount of blood loss, doctors will perform a hysterectomy.

“It’s a very difficult conversation,” Viteri said. “In the case of Katie, we knew that we didn’t want to have more babies later on, but this can happen when women are young. They may want to have bigger families. It’s always a hard conversation that we need to have.”

Thankfully for Katie, doctors knew about her condition early and at 34 weeks little Harrison was born.

“He is eating on his own, whenever he wants and that is very awesome,” Ibarra said. “That’s what a normal newborn would do.”

“Delivering around 34 weeks, given her circumstances, we felt it was a good trade off after the baby had received the steroids to mature,” Viteri said. “Having a little bit of prematurity in exchange of a healthy mom and a healthy baby, for us, I think has been a huge success.”

Today, every day and every moment is a blessing.

“Every little milestone is amazing,” Ibarra said. “Like when he went off his CPAP, when he wasn’t on oxygen anymore, when he started to really take oral feeds. That was, just every little thing is amazing. You jump up and down. Just to stay healthy. That’s the main goal.”

Dr. Viteri recommends that expecting mothers who have had a prior C-section get an ultrasound early.

That way doctors can evaluate the area where the placenta is and determine if you have a form of placenta accreta.