Placenta accreta occurs when a placenta attaches too deeply to the uterine wall. People who have had a caesarean section are at a greater risk of developing placenta accreta. It’s a serious condition that may cause severe hemorrhaging requiring transfusions and admission to the ICU. Other risks include premature birth, hysterectomy and even death. An early diagnosis can help healthcare providers consult colleagues with expertise in various fields to minimize complications.

Placenta accreta affects about 1 in 650 pregnancies. The occurrence has increased significantly, mostly due the higher rate of caesarean sections.

Delivery by caesarean hysterectomy is recommended between 34 and 36 weeks of pregnancy to minimize the risks to the pregnant person and the baby. Delivery may be scheduled prematurely if the person goes into labour early, experiences vaginal bleeding or other related complications.

The team at CHU Sainte-Justine, influenced by a number of factors seen over the past 5 years, decided to re-examine the treatment for placenta accreta. Specialists in the fetal-maternal clinic and in advanced gynecologic surgery, anesthesiologists and radiologists work together to ensure an early diagnosis and quick, adaptive care. Regional anesthesia is used instead of general anaesthesia, which reduces risks and provides better pain management. It also means that someone close to the patient can be with them during the surgery.

An expert taught a little-known surgical technique that reduces blood loss, surgery time and the likelihood of an ICU admission. Five gynecologists are now proficient in this technique.

Project submitted by :

Andrée Sansregret, Obstetrician-Gynecologist

Contributors :

Émily Bander, MD, FRCSC
Simon Benoit Dubé, MD, CM, FRCSC
Andréeanne Jodoin, MD,M.Sc, Cand. FRCSC
Suzy Gascon, MD, FRCSC
Diane Francoeur, MD, FRCSC
Élise Monceau, MD, FRCSC
Caroline Gauthier, MD
Janie Benoit, MDCM, FRCSC