WOMENS-HEALTH Messages for March, 1999: Placenta Acretia/Incretia

Placenta Acretia/Incretia

From: Carolyn (anonymous@obgyn.net)
Tue, 2 Mar 1999 21:25:16 -0600 (CST)

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I posted this before but received no response. I thought I'd try again.

I delivered my third child in Sept of last year. My first was induced without any problems, vaginal delivery. My second, I had another vaginal delivery but I had a "retained/deteriorated" placenta which had to be removed manually and was in pieces. I don't know the location of the placenta. My third pregnancy ended in a miscarriage followed by a D&C and a VERY quick recovery. My last pregnancy, the placenta was low lying and anterior at my 18 WK US. It did move up though. When I delivered my third child, the placenta did deliver in one piece, but I hemorrhaged, lost about 4 liters of blood, and required emergency surgery. My Dr told me later that he believes my second pregnancy may have been a case of Placenta Accretia and this pregnancy was placenta incretia (the accretia he is guessing at because he did not deliver that child). I escaped with my uterus still intact, the surgery removed pieces of placenta still imbedded in my uterus.

So, I have been told that any subsequent pregnancy could progress to the next step, placenta procretia, and I would lose my uterus. I would like to know the following:

Does placenta procretia ALWAYS follow placenta incretia?

Does it depend on where the embryo implants?

If the embryo did NOT implant on the anterior side, would my chances of this happening be the same?

Is there any way to determine before another pregnancy if there is something on the anterior side that is making this more likely (as possibly a c-section incision, which I DO NOT have), like a cyst or something? Would a cyst make this more likely?

IF I did get pregnant again, and it did implant on the anterior side, is it a foregone conclusion that the placenta would again imbed itself in my uterus? How likely is an US going to be at picking this up, especially if it is known to look for it?

Finally, IF I did end up having my uterus removed, aside from not having periods, what would the effect of this be on my body?(I'm assuming my OB would leave the rest of my reproductive organs intact as I have never had a problem with any them...no cysts, no bad paps...nothing)

Thanks.

--
Carolyn

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