Placenta accreta: Understanding Specialist Birth Planning

Placenta accreta spectrum describes a placenta that attaches abnormally firmly to the uterine wall and may extend into deeper tissue. It can cause severe bleeding when birth and placental delivery take place. When it is suspected during pregnancy, specialist planning helps the team prepare the people and facilities needed for your care.

Understand why you have been referred

A previous caesarean or other uterine surgery, especially together with a low placenta, can increase concern about abnormal attachment. Having a risk factor does not itself establish the diagnosis. Ask which part of your history or scan led to the referral.

The low placenta guide explains how location is assessed. Accreta assessment asks an additional question: how the placenta is attached to the uterus and surrounding structures.

Ask what further imaging can clarify

An experienced clinician may use ultrasound with Doppler to examine the placenta. MRI may sometimes add information for planning, particularly when ultrasound leaves questions about the extent of involvement. It is not required for everyone.

Imaging is interpreted alongside your history. A scan without obvious signs does not exclude every case. Ask what is known, what remains uncertain and whether the current recommendation is based on suspicion or a more definite finding.

Meet the team planning your birth

Suspected accreta usually leads to care through a specialist service. Planning can involve obstetric and surgical clinicians, anaesthesia, blood transfusion services, critical care and the neonatal team. The exact group depends on the expected needs.

Ask where birth is planned, which appointments can remain local and who coordinates messages between teams. If the specialist hospital is far away, discuss travel and the plan for urgent symptoms while you are closer to home.

Discuss possible surgery in clear terms

The team should explain the proposed operation, possible blood loss and whether removal of the uterus, called hysterectomy, may be needed. This discussion can be difficult, especially when you hope for future pregnancies. Ask for the explanation again, including what choices are realistic in your circumstances and what cannot be predicted in advance.

Do not assume that leaving the placenta in place guarantees preservation of the uterus or avoids later complications. Any such approach needs specialist discussion and a detailed follow up plan.

Keep an urgent plan alongside the booked plan

Birth may be recommended before the due date, but there is no single timetable suitable for every case. Our birth timing guide helps you prepare questions about this decision.

Contact maternity care immediately for bleeding or new pain. Heavy bleeding, severe pain or faintness needs emergency care. A scheduled specialist procedure does not mean you should wait at home with new symptoms.