PLACENTA ACCRETA

[claricemaala]

I do not know where to really post this but I need to talk to someone (as a buddy).
So I went back to my high risk OB to have a 6 week follow up post pregnancy today. I was actually very sad to leave for I have gotten so close to her and her NP during the 8 .5 months and weekly follow up . Anyways, we had gotten into discussion re: possible next pregnancy for me. I have always wanted 3 kids . I gave birth via C section to all my three kids with the most recent one this past Feb 2012 (carried my baby full term at 37 wks and 5 days and no eclamapsia). Unfortunately , my second one after a successful C section and despite being born healthy at 31 weeks went to heaven after 9 days due to NEC (necrotizing entercolitis). So I have two live children.
Another issue is that I am nearing 40 by end of 2013. I will turn 39 years old this year and with the growing concern of advance maternal age on top of my chronic hypertension and history of preeclampsia the idea of getting pregnant again seems to be against all odds. Moreover, since I just had a baby I cannot get pregnant until 18 months to let my body recuperate and the C section would healed.

Anyways, the point of this topic is I would like to know if anybody had heard of PLACENTA ACCRETA? And if so have anybody been discouraged to get pregnant again after having 3 section because of the risk to both the mother and the unborn child. Apparently, it is not recommended to get pregnant after 3 C section beacuse of higher surgical risk and also this PLACENTA ACCRETA thing.

Honestly, I want three kids. It could certainly be for my selfish reasons. Since I lost one of my sons and now have two live children I would like to try for another in a couple of years.But it could also be this selfish reason that my children could be motherless if anything happen to me. That is something I do not want to happen. Apparently Placenta accreta is life threatening and it could kill me.
So I am just plugging it here. I still have to search more about this topic.

Wikepedia definition:
Placenta accreta is a severe obstetric complication involving an abnormally deep attachment of the placenta, through the endometrium and into the myometrium (the middle layer of the uterine wall). There are three forms of placenta accreta, distinguishable by the depth of penetration.
The placenta usually detaches from the uterine wall relatively easily, but women who encounter placenta accreta during childbirth are at great risk of haemorrhage during its removal. This commonly requires surgery to stem the bleeding and fully remove the placenta, and in severe forms can often lead to a hysterectomy or be fatal.

[ktsl123]

I wouldn't worry about that. It is not a common thing. There are time when a Mom may need a blood transfusion to replenish bloodloss in a situation like this. I would not worry seriously.

[angieb]

18 months? Yeesh. My OB was fine with me trying again after 9 months though my mfm preferred me to wait a year. I got pregnant again about 10 months pp and they aren't worried about it. With my first c-section (vertical incision) there was about 11 months between pregnancies and my OB was really impressed with how fantastic it had healed when she checked it during my second c-section. Unless you wanted a vbac, or had high blood pressure or other issues, 18 months seems ridiculous to me personally.

Placenta accreta is a risk- a pretty small one luckily- of c-sections and future pregnancies. Since I've had 2, they are going to keep an eye out for it this time. Last time my placenta was not anywhere near the scar-not even on the same side- so then there's not really a risk.Hopefully that will be the case this time too. My mfm said she fully expects to be able to give me the ok for one more preg- which would be 4 c-sections.

[claricemaala]

18 months I think means 18 months from last birth to next delivery of next baby.The just use the word freely and open for a lot of interpretation. I guess I can get pregnant at and 10 months and then give birth 8 months later. If I make it without preeclampsia, that is.

I know 18 months seems to be too long but it seems to be the general standard (if there is such a thing) from all the obs I have met and consulted with even after my 2nd C section. Apparently this docs have dealt with a lot of placenta accreta a lot.
Reading your posts made me feel better. I was so depressed after hearing I cannot have another baby. I would like to have a 4th pregnancy and my last!
But of course I still have time to think about this whole thing. My new baby is only 5 weeks old. My body needs to recuperate a lot for now.

[angieb]

Ah okay, that makes more sense about 18 months between deliveries. With AMA a factor, if you were going to try again, I would think you'd want to do so sooner than later. Not only for genetics but fertility and everything too.

Placenta accreta, from what I understand, is when the placenta starts growing next to or in severe cases even through a previous scar. It's hard to see prenatally, there's not much they can do to "treat" it, and it can be very life threatening for mom and baby. So I definitely understand why it freaks ob's and MFM's out. But for it to even be a risk, your placenta has to grow on the same side of the scars. If the placenta is 'above' the uterus, for example, then there's not really any risk. Placentas can move a bit but they don't generally switch sides or entire locations, etc., at least from my very basic and general understanding. With my vertical incision, one of the MFM's I consulted with was more concerned about accreta than pre-e even and told me I'd probably spend my pregnancy on bedrest because of that. The other MFM wasn't concerned about accreta at all. And sure enough, by about 10 weeks, they were able to determine my placenta was in a great location not near the scar so that risk was ruled out pretty early on. On the flipside, I think we had a poster who did have a little bit of concern with it--Ashley (Ruby608 http://preeclampsia.org/forum/viewtopic.php?f=17&t=40008) They were a little concerned about it for awhile but her placenta moved away or they were able to determine it was okay, and she had a healthy baby and her pregnancy was fine. So anyway, it *can* be a big deal, or it can be a moot point. I'm not sure that the risk of accreta would deter me from another pregnancy, although when they happen, it sounds very risky and scary, so you would want them watching for it early.

[kmokashi]

I have a friend who is 39 right now and with her 6th pregnancy, and they are watching her closely for this condition. However, there are many women who have more than 3 children via C section, and the I agree with many others who have mentioned- I too don't think it necessary to wait 18 months. I for myself and nearly 40 (in May) and pregnant, so I would say go for it!

[flori]

Not much to add on accreta, but it's funny to hear the different interpretations of the 18 month rule, which I had never heard about until recently and now here it is again.

I just met with an MFM who said 18 months from conception to conception, which would make approximately 9 months in between pregnancies (if everything went well). I guess it's all the same time frame in the end.