Surviving Placenta Accreta
I died last year and was lucky enough to get another go at life. I can’t tell you what heaven was like but my waiting room was filled with long gone comedians who once were on Hollywood squares and my grandmother. It was warm, bright, and I laughed. Then I woke cold, confused, in the worst pain I have ever felt. I was told to cough, they yanked a tube out of my throat, and then I threw up.
It took months to feel human again, months to stop crying, months to close my eyes without seeing what played out in that delivery room. Dying is pretty awful when you are not ready to go. You would think that when you survive it you would have a new zeal for life. You do for a moment. And then you discover it wounds you in ways you can’t imagine or see.
Placenta Accreta is an obstetrical condition that affects 1 out of 533 pregnancies. In the 1970’s it was 1 out of 2500. The rate of cesarians has made what once was rare commonplace.
Placenta accreta is a serious pregnancy condition that occurs when blood vessels and other parts of the placenta grow too deeply into the uterine wall. There are 3 degrees or levels of severity accreta, increta, and percreta.
Accreta is when your placenta attaches too deeply to your uterine wall, increta is when it invades the muscles of that wall, and percreta is when it grows through the wall and attaches to nearby organs. Specifically your bladder in most cases.
As many as 90% of patients with placenta accreta require blood transfusion, and 40% require more than 10 units of packed red blood cells. Maternal mortality with placenta accreta has been reported to be as high as 7%. Maternal death may occur despite optimal planning, transfusion management, and surgical care.
Placenta accreta appears to be more likely when a mother has uterine scarring from a c-section or D&C but has been known to occur with no prior uterine damage.
Early detection is of the utmost importance. It can save a mother’s life and in many cases her uterus. Early detection allows surgeons the ability to minimize blood loss. Treatment usually consists of a preterm c-section and hysterectomy, if a woman would like to save her fertility they may leave the placenta in situ. Leaving the placenta in situ and treating with methotrexate allows it to be absorbed back into the body.
Mine went unnoticed till I delivered my son vaginally. I had risk factors. At one point my perinatal doctor even said your placenta appears to have attached to the wall of your uterus funny. That she would monitor it. An MRI is a useful tool for early detection. But the most important factor is having doctors experienced with this disorder. I did not have those doctors. Even with weekly 3D ultrasounds mine went undetected.
I had placenta percreta, it grew through my uterus and attached to my bladder. The portion of placenta that my doctor manually delivered caused my uterus to abrupt. I received 9.5 units of blood, was intubated, central lines in my neck and arms, uterus removed, and bladder repaired. I luckily escaped cardiovascular damage.
When my doctor came to my ICU room she was in tears. She told me she was thankful that I had made it. That she thought she was going to lose me. That she and I were lucky that I lived. It was a rare human moment, she appeared more fragile than me. I even felt sorry for her. Over the course of this year I have questioned, blamed, and even hated the doctors whose care I was under. I have reached a point of clarity and even forgiveness. But above everything else I want awareness to this condition. I had no idea what is was till I survived it.
1 out of 533 pregnancies.
Ask questions, be informed, be your own advocate.
And please spread the word.
Knowledge is power and it can save a life.