2 prior placenta accreta

[saphirize]

This is my first time posting. I am 33 y/o with four children and now 13.5 weeks pregnant with my 5th. I have had two previous placenta accretas and am concerned about it again. The first time was with my second child, and I had no idea I had placenta accreta, and the second time was with my last child. I knew about this one after birth but did not realize the severity of it although my husband says the doc talked about it extensively. I do not remember very much about that birth, just realized with this pregnancy and only after pulling my medical records that I had blood transfusions after the last birth and two D&C's. My first child was born uneventfully, second placenta accreta, third by c-section due to his presntation, and fourth one month early with placenta accreta. My problem now is, my OB does not seem all that concerned, ultra sounds are fine, she just says I may not have a choice but to have a c-section. I live in a small town and have to travel 30 minutes just to see a regular OB, and then next biggest town is about an hour away with high risk docs. My concern about that is having to travel so far in the event of an emergency. The hospital in my town does not even have an OB ward, nor OB docs. Any thoughts or opinions would be greatly appreciated.

[Slorayne]

Dear Saphirize,

Your situation is somewhat like mine. I am pregnant with my 4th, and have had 3-4 placenta accretas before. (I think one of my miscarriages had a PA). Every one of my live deliveries have ended in a retained placenta, one of which resulted in heavy bleeding 4 months later. I've never had a preterm delivery, all the babies have been fine, and I've never had a life-threatening hemmorahge. My mother, too, had PA with me. She had 4 other babies but didn't get PA with any of them.
I've had 5 D&C's, (one after each live delivery, one 4 months after a live delivery, and one with a miscarriage), and one apendectomy while pregnant with my 2nd child. But I've never had a c-section before. I'm kind of scared to ask for one since there may be a higher likelihood of bleeding and hysterctomy. (I wouldn't mind having my tubes tied though.) I think with this delivery I am even more likely to have PA than ever before. I go to see my doctor the day after tomorrow and I plan on asking him about my options. I know that it is very difficult to diagnose PA, but I'm hoping that he will at least be willing to try, (and that my insurance will cover it!).
In the meantime, I would encourage you to be postitive. PA sounds scary and the info on the internet makes it even sound morbid. But if you can find a good and supportive doctor I'm sure you will be fine. If you are religious, make your plea to Heavenly Father, have those around you do the same, and I believe you will be blessed.

Hang in there!

Sara