Diagnosing placenta accreta: what to know

Placenta accreta occurs when the placenta attaches too deeply into the womb wall and may not separate normally after birth. Ultrasound can assess placental position, the area where it meets the womb and blood-flow patterns. A history of caesarean birth, placenta previa or uterine surgery can affect clinical suspicion. Magnetic resonance imaging may be considered when ultrasound findings are unclear or more detail is needed for planning. A scan can raise or lower suspicion, but the final extent may only become clear during birth surgery.

Ask to be cared for by a maternity team experienced with abnormal placental attachment. Planning may cover timing and place of birth, blood availability, anaesthesia, surgical support and what may happen if bleeding occurs. A caesarean birth may be recommended, and hysterectomy may be discussed when the placenta cannot safely be separated. Your preferences, future fertility plans and the pregnancy findings should be part of that conversation.

Contact maternity services immediately for vaginal bleeding, contractions, pelvic pain, fluid loss, dizziness or fainting during pregnancy. Heavy bleeding, collapse or breathlessness is an emergency: call local emergency services. Do not wait for a scheduled scan if symptoms begin, even when you have not received a confirmed diagnosis.

Ask where the placenta is attached, what the scan can and cannot show, whether further imaging is useful, and which specialists will attend the birth. Discuss the proposed birth plan, possible bleeding management, recovery and how surgery could affect future pregnancies.