Invasive Placenta: Risks, Diagnosis, and Delivery Options

Invasive placenta

Hello, I am currently at 31 weeks and 3 days of pregnancy.
During my prenatal check-up, it was found that I have a condition of placenta accreta, but the doctor mentioned that it cannot be confirmed with 100% certainty yet.
Is it possible for the ultrasound results to change in the future? Is there a risk to life associated with this condition? Should I consider an early cesarean section?

Miss Hong, 30~39 year old female. Ask Date: 2003/07/31

Dr. Lü Lizheng reply Obstetrics and Gynecology

Hello! 1.
Invasive placenta, according to current diagnostic techniques, is primarily assessed using ultrasound.
However, due to variations in equipment resolution and physician experience, the accuracy ranges between 40-60%, so it is not definitive.
It is recommended to visit a medical center for a high-level ultrasound evaluation.
2.
Currently, there is no need for an early cesarean section, but it is advisable to transfer to a medical center for delivery for greater safety.
3.
Typically, issues arise after the fetus is born, particularly when attempting to separate the placenta from the uterus.
Since the placenta is implanted within the myometrium, it may not detach completely, leading to exposed blood vessels that are difficult to control, which can result in postpartum hemorrhage.
This can be managed with uterotonics and surgical intervention for hemostasis.
Best wishes for health from Dr.
Lu Li-Cheng, Department of Obstetrics and Gynecology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2003/07/31

More Info

Invasive placenta, often referred to as placenta accreta, is a serious condition where the placenta attaches too deeply into the uterine wall. This can lead to significant complications during pregnancy and delivery. Given your current situation at 31 weeks and the uncertainty surrounding your diagnosis, it’s crucial to understand the risks, the role of ultrasound in diagnosis, and the potential delivery options.

Firstly, regarding the diagnostic aspect, ultrasound is a key tool in assessing placental location and its relationship with the uterine wall. While your doctor has indicated that they cannot confirm the diagnosis of invasive placenta with 100% certainty at this stage, it is important to note that ultrasound findings can evolve as the pregnancy progresses. As the uterus expands and the placenta matures, follow-up ultrasounds may provide clearer insights into the placental attachment. In some cases, additional imaging techniques such as MRI may be recommended to further evaluate the placenta's position and its invasiveness.

The risks associated with invasive placenta are significant. If the placenta is indeed accreta, there is a heightened risk of severe hemorrhage during delivery, as the placenta may not detach easily from the uterine wall. This can lead to complications such as hysterectomy (removal of the uterus) if the bleeding is uncontrollable. In severe cases, it can pose a risk to the mother’s life. Therefore, it is essential to have a comprehensive plan in place for delivery, which may involve a multidisciplinary team including obstetricians, anesthesiologists, and possibly hematologists.

Regarding the timing of delivery, many healthcare providers recommend planning for a cesarean section (C-section) at around 34 to 36 weeks for women diagnosed with invasive placenta, especially if there are signs of complications or if the placenta is confirmed to be accreta. This is done to minimize the risk of spontaneous labor, which could lead to severe bleeding. The decision on the exact timing should be made collaboratively with your healthcare team, taking into account your specific circumstances, the health of your baby, and any signs of complications.

In terms of life-threatening risks, while invasive placenta can lead to serious complications, with proper medical care and planning, many women can have successful outcomes. It is crucial to maintain open communication with your healthcare provider, attend all scheduled appointments, and report any unusual symptoms such as heavy bleeding, severe abdominal pain, or changes in fetal movement.

In summary, while the diagnosis of invasive placenta can be concerning, ongoing monitoring through ultrasound and careful planning for delivery can significantly mitigate risks. It is essential to work closely with your healthcare team to ensure the best possible outcome for both you and your baby. Always feel empowered to ask questions and express any concerns you may have during this critical time.

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