Thursday, January 21, 2010

Placenta Previa and Placenta Accreta

Turns out my mother's birth experience with me involved her placenta not coming out after I did. In hospitals they only wait 30 minutes for the placenta, even though it has been known to take up to two hours after birth to come out safely. However, in the hospitals they worry about placenta accreta, or the placenta remaining attached to the uterine wall, which can cause severe bleeding. Thusly, they anesthetized my mom and went in and got it! So today's lesson, for myself and any readers, will be on placenta accreta.

The condition of the placenta attaching too deeply to the uterine wall is known as either placenta accreta, placenta increta, or placenta percreta, depending on the severity and deepness of the placenta attachment. Approximately 1 in 2,500 pregnancies experience placenta accreta, increta or percreta.

The cause is unknown, though it can be related to either previous cesarean deliveries or a condition known as placenta previa. This occurs when the uterus is covering the cervix and is diagnosed during pregnancy. Placenta accreta is present in 5% to 10% of women with placenta previa. Placenta accreta if difficult to diagnose and is usually not confirmed before labor.

 If it occurs in childbirth, the placenta will be manually removed before there is too much hemorrhaging. In severe cases a hysterectomy, or the removal of the uterus, may be required.

My mother doesn't really remember it, she says she was groggy, so she's not sure if she actually had placenta accreta or maybe just a retained placenta and they were worried about placenta accreta.

There are ways to help your placenta along if it is taking a while. Breastfeeding the baby or nipple stimulation helps the uterus to contract and expel the placenta. Occasionally, changing to an upright position lets gravity help the placenta out. You may also have a managed third stage, where you're given an injection of oxytocin to make your uterus contract.

By the way, I don't recommend a google image search of 'retained placenta.' Its mostly cows.

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