Appropriate treatment for preserving uterus?

[Lisa A]

Hi Ladies:
I'm so happy I found this board and hope you can help me in evaluating my doctor's recommended plan for treating my "potential" accreta. I have been diagnosed with a placenta previa and perhaps an accreta as well. I have another u/s this Tuesday (at 33 weeks) to look at the previa again. What makes the doctors suspiscious of an accreta are increased vascularity in the lower uterus and the border between uterus and placenta is fuzzy-not clearly defined. If it still looks like an accreta I'll have a follow-up MRI to confirm. I had Asherman's Syndrome--scarring throughout the uterus caused by a d&c--which alerted my OB to the potential for previa/accreta from the beginning. I want him to use all conservative measures possible to save my uterus. This is my third child, and I am 42, but I still have frozen embryos and want to keep my options open. His treatment plan includes having an interventional radiologist insert balloon catheters in the uterine arteries to reduce blood loss, possibly oversewing the uterus at the site of the accreta, and having a gynocological oncologist on call in case its an increta. I also got a second opinion and will discuss all my options with both doctors again after my u/s on Tuesday. My questions: will knowing ahead of time and being prepared for the accreta significantly increase my chances for saving my uterus? Does anyone know of other procedures (besides leaving the placenta inside) that I should discuss with my doctor? Does the week you deliver make a difference in how hard/easy it is to remove the accreta? Right now because I have the previa, and am currently on bedrest after my first bleeding episode, my OB is talking about a scheduled c-section at 36 weeks. Thanks for any advice, and thanks everyone for sharing your stories.
Lisa

[coachjodi]

Lisa,

I'm so sorry you have to deal with this. Because of your Asherman's chances are that you do have an accreta. I have read that after the 37th week the chances of harm to the mother and baby increase significantly so scheduling the C for 36 weeks is actually great. It sounds like your doctor has all bases covered. There is a member on this board who did deliver via c-section with knowledge of accreta. She might be able to give a bit more information than I can. Her doctor was able to save her uterus. Please keep us posted, as I also have a bit of Asherman's (probably from the accreta) and will probably start trying again soon. I am expecting that I will have another accreta as well [img]tongue.gif[/img]

Jodi

[pmciufo]

Lisa,

Welcome. I believe Jodi was refering to me as one who had a scheduled c-section with accreta. I was diagnosed with placenta previa too and had a couple weeks of bed rest after some bleeding. My dr suspected an accreta (had one with 1st preg) and after an MRI it was confirmed. I had a scheduled c-section at 37 weeks and also had the balloon catheters inserted as a precaution.

It sounds like your drs are doing everything possible. You seem to be in good hands. A lot will depend on how invasive your accreta is. Which your drs may not have a clear view until you deliver.

My 2nd accreta was just a slight case and they were able to get my placenta out. The previa did complicate things for me since my placenta was laying on top so when they started the c-section, they were cutting into the placenta. Thankfully everything turned out better than we hoped.

Please keep us informed. If there are any questions I can answer, please don't hesitate to ask me.

Wishing you only the BEST.

-Paige