Placenta accreta bleeding: what to know

Placenta accreta spectrum describes placental tissue attached too deeply in the uterine wall. Bleeding may occur if the placenta is near the cervix, if the lower uterus stretches, or when the placenta is separated after birth. The amount can change quickly, so the appearance of a small bleed does not predict what will happen next.

Bleeding is not proof that accreta is present, and some people with accreta have no warning bleed before delivery. Your maternity team may review scan findings, previous caesarean births and other uterine procedures when judging risk and arranging care.

Report any vaginal bleeding to your maternity unit straight away, even if it stops. Follow the instructions you are given about assessment, activity and returning to hospital. Keep your antenatal appointments and carry your maternity information when travelling. Ask who to call outside clinic hours.

If accreta is suspected, a planned birth in a suitably equipped hospital allows obstetric, anaesthetic, surgical, blood-bank and newborn teams to prepare. The plan may include a caesarean section. Depending on the attachment and bleeding, doctors may discuss hysterectomy after birth.

Seek emergency help for heavy or continuing bleeding, clots, severe abdominal pain, contractions, faintness, marked weakness, breathing difficulty or reduced fetal movement. Lie on your side while waiting for help if you feel dizzy, and do not drive yourself if you are unwell. Use emergency services rather than waiting for a reply to a message.

Ask what features on your scans raise concern, what bleeding plan applies to you, where you should attend at any hour, and how your birth team would respond to sudden blood loss. Clarify whether a caesarean section or hysterectomy is being considered and why.