Placenta Accreta, Birth Injury, and Medical Malpractice

Placenta accreta is a condition in which the placenta does not properly separate from the uterus during labor and delivery because it has grown too deeply into the uterine wall. This condition is usually diagnosed during routine prenatal testing during ultrasound scans. If undetected and not properly treated, placenta accreta can cause severe hemorrhages, which can pose a serious health threat to both mother and child.

Placenta Accreta

What is Placenta Accreta?

Placenta AccretaThe placenta is an organ that transports oxygen and nutrients from the mother to the baby and removes waste from the baby during pregnancy. In a normal pregnancy, the placenta is attached to the wall of the uterus until birth. Once the baby is delivered, the placenta then naturally separates from the uterine wall and leaves the body through the birth canal.  Sometimes, however, the placenta is unable to detach properly because of a condition known as placenta accreta.

Placenta accreta occurs when the blood vessels and other parts of the placenta have grown too deeply into the uterine wall. This complicates the natural separation of the placenta from the uterus and can mean that parts or the entirety of the placenta are left attached to the uterine wall. Placenta accreta can cause severe blood loss, which can impact the health of both mother and child.

Placenta increta is a similar but rarer placental pathology, which occurs when the placenta is attached deeper into the uterine wall and into the actual uterine muscle. Still rarer is placenta percreta, in which the placenta fully penetrates the uterus and attaches to another organ in the body. According to the American Pregnancy Association, 1 in 2,500 pregnancies involves one of these types of placenta placements: accreta, increta, or percreta.

Signs of Placenta Accreta

Placenta accreta may not cause any signs or symptoms during pregnancy. However, women may experience bleeding during their third trimester. If you experience any bleeding during your pregnancy, please consult with a medical professional immediately. It is critical that medical personnel detect, diagnose, and properly manage any bleeding during pregnancy.

Placenta accreta is usually diagnosed during prenatal care when medical practitioners conduct routine ultrasounds. For this reason, it is imperative that medical professionals administer ultrasounds on a regular basis and interpret them meticulously. If a patient has a concern, however, and feels they need to be examined via ultrasound, they can request one at any point during the pregnancy.

Placenta accreta, placenta increta, and placenta percreta are all very serious conditions and make a pregnancy high-risk.

Risks and Complications Associated with Placenta Accreta: The Mother

Under normal circumstances, the placenta will separate from the uterine wall completely during a vaginal delivery. In placenta accreta, this separation can cause severe hemorrhaging in the mother, which can cause life-threatening blood loss and severe drops in blood pressure.

In general, the management of placenta accreta involves a planned cesarean delivery with an experienced surgical team equipped to remove the placenta and vessels from the uterine wall. In certain instances, removal of the placenta may be combined with a hysterectomy (total removal of the uterus). The medical professional will be able to devise a plan for delivery which will optimize outcomes for both the mother and the baby.

Risks and Complications Associated with Placenta Accreta: The Baby

Placenta accreta can result in premature delivery, which can cause complications of prematurity. These can include cystic periventricular leukomalacia (PVL), intracranial hemorrhages, and other injuries. Because of this, it is crucial that medical personnel detect, diagnose, and properly manage placenta accreta on prenatal ultrasound.  Once placenta accreta is diagnosed, the doctor will be able to recommend ways of managing the pregnancy to prepare for any risks and complications.

It is a physician’s job to identify and treat medical conditions, such as placenta accreta, which can lead to adverse outcomes for babies. Premature birth can put babies at higher risk for certain complications and birth injuries because they are not yet fully developed and have low birth weights. Premature babies may be at risk for hypoxic-ischemic encephalopathy (HIE), which is a brain injury caused by oxygen deprivation. Another potential risk is that babies born prematurely or that experience HIE may develop cerebral palsy, which is a group of non-progressive motor conditions that cause physical disability.

Risk Factors for Placenta Accreta

According to the American College of Obstetricians and Gynecologists (ACOG), women who have had cesarean deliveries and suffered myometrial damage, as a result, may develop placenta previa around the uterine scar. This puts them at greater risk for placenta accreta.

The more often a woman undergoes uterine surgery, the higher her risk for placenta accreta.  Because of this, it is highly important that medical professionals obtain a thorough and accurate understanding of a woman’s medical history, in order to properly evaluate risk factors that may contribute to structural abnormalities of the placenta.

Other risk factors for placenta accreta include advanced maternal age, multiple pregnancies, previous myomectomy, thermal endometrial ablation, vigorous curettage resulting in Asherman syndrome, uterine artery embolization, and submucous leiomyomas.

Treatment of Placenta Accreta

The treatment plan for women with placenta accreta involves a doctor monitoring the condition, planning the delivery, and performing surgery which will save the uterus and protect against hemorrhaging during vaginal birth. In some cases, if the placenta accreta is severe, a complete hysterectomy may be necessary.

The physician will devise a treatment plan to protect the mother and fetus. Adverse outcomes are often preventable. If the physician fails to appropriately diagnose and treat placenta accreta, based on clinical findings and ultrasound screening, he or she may not be providing the care required by law. Failure to match the standard of care when presented with certain clinical findings can be medical malpractice.

Legal Help for Birth Injuries from Misdiagnosed Placenta Accreta

The award-winning birth injury attorneys at Reiter & Walsh ABC Law Centers have helped dozens of children affected by birth injuries such as hypoxic-ischemic encephalopathy (HIE) and cerebral palsy. Our team has over a century of legal experience in birth injury litigation, and we have handled an array of cases involving premature birth injuries, HIE, cerebral palsy, and medical mistakes related to pregnancy, labor, delivery, and neonatal care. Our birth injury attorneys are based in Detroit, Michigan, but we handle cases all over the U.S.

If your child has a birth injury such as hypoxic-ischemic encephalopathy, seizures, or cerebral palsy, contact Reiter & Walsh today. Our birth injury attorneys are available to speak with you 24/7, and there is no fee unless we win your case.

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Disclaimer: This page is intended solely as an educational tool for parents. It is not intended as, and should not be mistaken for, medical advice. If you have any medical concerns about your pregnancy, such as abnormal bleeding, please seek medical attention immediately. Bleeding during pregnancy is a condition that must be evaluated and treated by a medical professional.

Further Reading on Placenta Accreta: