Scars from previous surgeries such as cesarean section, fibroid removal, or dilation and curettage (D&C) can increase your risk for placenta accreta. There’s also a greater chance of placenta accreta if your placenta is set lower in your uterus (placenta previa), making it easier for the placenta to deeply attach to or pass through uterine walls. Because of how the placenta attaches to the uterus, a hysterectomy is necessary.
Placenta accreta is a rare condition that can present complications during your pregnancy and the delivery of your baby if your placenta grows too deeply into the uterine wall. Part or all of the placenta may remain attached after childbirth, which could cause severe bleeding. If you’re at risk for this condition, you’ll receive care from Duke perinatologists who are experts in the medical and surgical care of women with this and other pregnancy-related complications. We are here for you from the moment placenta accreta is suspected, during your pregnancy, and through your baby’s delivery.
Causes of Placenta Accreta
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Testing for Placenta Accreta
Placenta accreta is typically discovered by a routine level II ultrasound that takes place during a routine obstetrics appointment between weeks 18 and 24 of your pregnancy. If placenta accreta is suspected, your obstetrician will see if the placenta attached itself to the muscles of your uterine wall. If this is the case, your doctor will coordinate additional care with experts from perinatology and radiology to ensure the safest outcomes for you and your baby.
Prenatal Care with Placenta Accreta
Since placenta accreta can’t be prevented, we begin coordinating your care as soon as you’re diagnosed. You’ll attend extra delivery planning and prenatal visits to keep you as healthy as possible throughout your pregnancy. You’ll be prepared for a premature birth, as placenta accreta can cause you to deliver earlier than your due date.
We prepare for any complications in delivery by involving our obstetric anesthesiologists, fetal diagnosticians, and blood transfusion specialists leading up to your delivery. Your care team will also include interventional radiologists, perinatologists (high-risk pregnancy doctors), and neonatologists.
Minimizing Impact of Blood Loss
The main risks of placenta accreta include heavy bleeding before and during delivery and damage to your organs during a cesarean section. Because mild anemia is common during pregnancy, your doctor will schedule pre-delivery iron infusion, which can minimize any blood loss and the reduce the need for blood transfusion. However, we’ll ensure we have blood ready if you need it, and our blood transfusion specialists will be prepared to perform a blood transfusion during or after your cesarean section.
If you prefer alternative blood products or support, we’ll work with the Duke Center for Blood Conservation to handle any religious, medical, or personal concerns.
Duke Regional Hospital is recognized among the best hospitals in the U.S. for maternity care by U.S. News & World Report for 2022-2023. The recognition notes our low rates of C-sections in people at low risk for pregnancy complications and other factors. Duke University Hospital's nationally-ranked obstetrics and gynecology program is the highest-ranked program in North Carolina, according to U.S. News & World Report for 2022-2023.
Virtual classes with instruction from Duke Health nurses who specialize in labor and delivery and caring for your new baby.
Why Choose Duke
With You at Every Step
From prenatal visits through birth and any needed follow-up surgeries, our experienced care team will help you with your diet and physical well-being. In addition to your doctor appointments, our virtual Prepare for Baby series can help you get ready for your growing family.
Specialized Care When Your Baby Needs It
Our Level IV Neonatal Intensive Care Unit holds the highest designation given by the American Academy of Pediatrics. This means we provide the highest level of neonatal medicine for babies born with complex problems.
A Growing Level of Expertise
Duke is part of the Pan-American Society for Placenta Accreta Spectrum, an international network of hospitals and experts in placenta accreta that shares research and results on the best ways to care for people with placenta accreta. This helps Duke doctors enhance their knowledge and improve techniques that keep you safe.