placenta accreta second prgnancy

[The small one]

Hi, this is my first time on this site. I am half way through my second pregnancy and had placenta accreta complication with my first pregnancy but was only told the name of it at my 20 week ultrasound this pregnancy. My first child will be 18 months old when this baby is born and I'm a little worried about being ill etc. at the birth this time. Can't seem to get any advice on if there's anything that can be done other than manage the situation at the birth, nor re. what are the likelihoods of it reoccuring this time. Any advice?

[coachjodi]

Hi and welcome! What was your exerience during the birth of your first child? Am I understanding you correctly when you said that you did not know you had accreta until you were 20 weeks along with your current pregnancy? In what context did they tell you this? Was it the same doc who delivered your first?

To answer your questions, unfortunately there is nothing you can do except manage the birth process. It is virtually impossible to detect accreta during a pregnancy without an MRI, and even then it is difficult. Did you deliver C section or ******l with your first? Your options for this delivery are to 1. deliver ******l and hope you don't have an accreta, if you do have an accreta, the doctors can leave the placenta inside and treat you with methotrexate (chemotherapy). Unfortunately this will mean that you probably won't be able to breastfeed and will be carrying your placenta around for a while until it either comes out or reabsorbs. It is a slow process but worth it to save your uterus. The other option is to have a c section at around 37 weeks during which the doctor can make a better attempt to remove the placenta or perform a hysterectomy if necessary. Either way, your doctors should have extra blood on hand and prepare for possible hemmhorage. This is not to scare you becauses I believe it is totally manageable if your doctors are prepared.

Hope this helps!

Jodi

[The small one]

Hi Jodi, thanks for the reply.

Yes, I was only told during this pregnancy what actually happened with the last one! My last pregnancy was basically fine but after my baby was born (regular delivery, not c-section) the placenta didn't deliver. I lost a fair amount of blood and was sent for surgery a couple of hours later where they tried to remove the placenta, but they were not able to remove it all. I stayed in hospital for 5-6 days on heavy doses of antibiotics etc. and with discussions about whether or not I needed a transfusion etc. In the end some parts left in came out a few weeks later on their own and the rest (if any left?) re-absorbed. I wasn't told why this happened or that it had a name. I asked more at my 20 week appointment this time around and was told it was placenta accreta and there was a high possibility it could happen again. (It was a different doctor referring to all the notes the hopsital kept after the delivery.)

My main concern now is that I've been told "wait and see" is the only option and obviously with a small child at home that's not ideal...

Thanks for the advice, any more would be appreciated!

[coachjodi]

I wish I could tell you something more, but unfortunately, wait and see is the only thing you can do at this point. I would request an MRI around week 33 since you are definitly high risk for another accreta. If nothing else, just make sure you and your doctor have a very clear and detailed birth plan. On the up side.....all could be fine so try to enjoy your pregnancy.

I can't believe that nobody told you what was going on last time around. Not that this will make anything better, and not that I endorse unnecessary law suits, etc BUT....if you have accreta again this time around, you definitly have cause to file suit (in my opinion anyway). You should have 1. been informed of the risk of having this again and 2. been given the opportunity to get some preventative work done prior to getting pregnant again...it just screams negligence on your old doctor's part.

PLEASE keep me posted!

Jodi

[rgfeld]

Originally posted by Small choc:
Hi Jodi, thanks for the reply.

Yes, I was only told during this pregnancy what actually happened with the last one! My last pregnancy was basically fine but after my baby was born (regular delivery, not c-section) the placenta didn't deliver. I lost a fair amount of blood and was sent for surgery a couple of hours later where they tried to remove the placenta, but they were not able to remove it all. I stayed in hospital for 5-6 days on heavy doses of antibiotics etc. and with discussions about whether or not I needed a transfusion etc. In the end some parts left in came out a few weeks later on their own and the rest (if any left?) re-absorbed. I wasn't told why this happened or that it had a name. I asked more at my 20 week appointment this time around and was told it was placenta accreta and there was a high possibility it could happen again. (It was a different doctor referring to all the notes the hopsital kept after the delivery.)

My main concern now is that I've been told "wait and see" is the only option and obviously with a small child at home that's not ideal...

Thanks for the advice, any more would be appreciated!

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<font color="#a62a2a" size="1">[ May 18, 2006 07:43 AM: Message edited by: rgfeld ]</font>

[rgfeld]

small choc,
if you're ever on this site again, I'd love to hear how things worked out for you in your second pregnancy. my wife is pregnant again after having accreta during her first pregnancy as well (although the doctors certainly identified it at the time).

we know the risks associated with accreta, but were not aware of the actual risk of getting accreta again, nor were most high-risk OB-GYN's we spoke with, given our unique situation of having had accreta during our FIRST pregnancy - not during a later pregnancy after having had a c-section previously. Your's is actually the first and only other instance I've heard of like ours, so I, again, would love to know how things worked out.

Take care,
rgfeld

[pmciufo]

RGFELD,

You commented that you had never heard of having an accreta twice in a row....I have had it. My first was an undiagnosed accreta. The dr didn't know until they tried to deliver the placenta. I was transfered to a larger hospital and the dr there decided to leave it in and treat with antibiotics and methrotrexate. Eventually everything passed or was reabsorbed. My 2nd pregnancy was under the care of this new dr and was diagnosed early with a slight accreta and precreta (low lying placenta). Because of the precreta, I had a scheduled c-section and they were able to remove all of the placenta while they were in there. Did require blood transfusion and a prior surgery of inserting balloons into my leg arteries as a preventive measure - which they utilized.

I'm deciding on a possible 3rd pregnancy but fear has kept me from that so far. Not sure what else my body may throw at me with the next one.

Good luck to you and your wife.

-Paige