Placenta accreta explained

Saint and North West might have another brother or sister to play with soon, after Kim and Kanye have reportedly hired a surrogate mother to carry their third baby. This decision comes as a result of Kim's experience of placenta accreta during her last two pregnancies.

Our midwife Kate explains this rare condition:

What is placenta accreta?

Placenta accreta is a condition in pregnancy where the placenta is attached and embedded too deeply into the wall of the uterus. Therefore, the placenta does not come away after the baby has been born. There are different types of placenta accreta depending on how deeply it has become embedded. It is not routinely screening for during your ultrasounds, however if it is suspected then you may be offered a further scan with a specialist to diagnose it.

How common is placenta accreta?

Placenta accreta is a rare, affecting 1.7 pregnancies per 10,000. However, there are some factors that raise the risk, including:

• if you have had a previous caesarean section
• if you have placenta praevia (low lying placenta)
• increasing number of pregnancies
• maternal age.

How does it affect a pregnancy?

Having placenta accreta does raise the risk going into premature labour. In addition, you may experience some painless vaginal bleeding, particularly later on in pregnancy.

What are the risks?

The biggest risk is heavy bleeding following the birth of the baby. If you have been diagnosed with placenta accreta then you would normally be advised to have a caesarean section at about 36-37 weeks of pregnancy. During your pregnancy you will see a consultant who will explain to you a care plan to manage bleeding during the caesarean section and the chance of needing a hysterectomy (removal of the uterus). They will also talk to you about having possible blood transfusions, if you do not wish to accept blood then they will advise you on other options and you may need to have your baby at a different hospital.

If it has not been diagnosed during pregnancy, and the placenta does not detach after the baby has been born then you will need to go to theatre to have the placenta removed and possibly have a hysterectomy.