In plain words
Placenta accreta spectrum is a group of conditions where the placenta attaches too deeply into the wall of the uterus. The placenta may not separate cleanly after birth, which can cause heavy bleeding. It is more likely when the placenta covers the cervix, or after a prior . It is usually found on the or ultrasound before birth. It is rare, but it needs planning. Many providers refer people to a center with a care team ready for surgery and blood transfusion. Your provider will explain the findings and the plan. Tell your care team about any heavy bleeding right away.
The deeper version
Placenta accreta spectrum (PAS) describes abnormal invasion of placental tissue into the , classified as accreta, increta, and percreta by depth of invasion. ACOG Obstetric Care Consensus No. 7 (2018) recommends antenatal diagnosis by ultrasound or MRI and planned delivery at a multidisciplinary center, given high rates of hemorrhage and hysterectomy. Jauniaux et al. (2019), in a systematic review and meta-analysis, report that prevalence has risen with cesarean rates and is highest with prior cesarean and . Management includes timing of delivery, surgical planning, and blood product availability, and the approach varies with severity and institutional resources.
Where it comes up
- Placenta previa and other placenta findingsPregnancy: Your Body
- Planning a cesareanGetting Ready for Birth
- Heavy bleeding after birth (hemorrhage)Birth and the First Days
- VBAC: birth after a cesareanGetting Ready for Birth
- What happens in a cesareanBirth and the First Days
What mothers here say about placenta accreta spectrum
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Sources
- American College of Obstetricians and Gynecologists — Obstetric Care Consensus No. 7: Placenta Accreta Spectrum (2018)
- Jauniaux E et al. — Prevalence and main outcomes of placenta accreta spectrum: a systematic review and meta-analysis. American Journal of Obstetrics and Gynecology, 2019