What are Placenta Adhesion Anomalies? How to Treat?

Placental adhesion anomalies refer to the fact that the placenta, which should only adhere to the inner layer of the uterus during pregnancy, adheres tightly to the depths of the uterine wall rather than to its normal place. The placenta is known as a structure that connects to the inner layer of the uterus (endometrium) to nourish the fetus and provide oxygen during pregnancy. Under normal conditions, after birth, the placenta naturally separates from the uterus and comes out. In placental adhesion anomalies, this process is affected and the placenta adheres more tightly or abnormally to the uterine wall. Details on the subject are with you in the rest of our article.

What are Placenta Adhesion Anomalies?

In some cases, the placenta cannot settle in its normal place. In this case, the risk of placenta adhesion anomaly increases.

Placenta Previa: It is the name given to the placement of the placenta covering the cervix. Having placenta previa increases the risk of placenta adhesion abnormality. However, not every previa has an adhesion anomaly.

Placental adhesion anomalies are examined under three main categories:

1. Placenta Acreta: It is the placenta adhering to the uterine wall more than normal. It refers to excessive adhesion from the innermost layer.

2. Placenta Increta: The placenta has adhered to the deeper layers of the uterine wall, but has not come out of the uterine wall.

3. Placenta percreta: The placenta may have come out of the uterus and even stuck to nearby organs (such as the bladder or intestine).

What are the Risks of Placenta Adhesion Anomaly?

Placental adhesion anomalies may lead to bleeding, pain, risk of premature birth, and in some cases, the placenta not being completely removed after birth. These situations may require serious medical intervention and are therefore considered high-risk pregnancies.

Who Gets Placenta Adhesion Anomalies?

Placental adhesion anomalies can occur in every woman, but some risk factors may increase the likelihood of developing these anomalies. We can list these risk factors as follows:

• History of placenta adhesion anomaly in previous pregnancies: Women who have experienced placenta adhesion anomaly in previous pregnancies may experience it in subsequent pregnancies.

• Cesarean births: One or more previous cesarean births may increase the risk of placental attachment abnormality.

• Surgical procedures performed in the uterus: Previous surgical interventions performed in the uterus may increase the risk of placental adhesion anomalies.

• History of placenta previa: The risk of placenta adhesion abnormality may be increased in women diagnosed with placenta previa in previous pregnancies.

• Age factor: Women aged 35 and over are a group with a higher risk of placental adhesion anomalies.

• Smoking: Smoking may increase the risk of placental adhesion anomalies.

• Fertility treatments: Fertility treatments, known as assisted reproductive techniques, may increase the risk of placental attachment anomalies.

• Patients who have had intrauterine infection

How Are Placenta Adhesion Anomalies Treated?

Placental adhesion anomalies are among the serious medical conditions. Therefore, treatment processes should be carried out by an expert healthcare team. Treatment plan; It may vary depending on the type of anomaly, week of pregnancy and other medical conditions. We can list the treatment methods for placental adhesion anomalies as follows:

• Early Diagnosis and Follow-up: Early diagnosis of placental adhesion anomalies is important. Pregnant women with risk factors should be followed by perinatology at regular intervals.

• Planned Caesarean Delivery: Women with placental attachment anomalies usually deliver by planned cesarean section. This reduces the risk of the placenta causing complications during labor that may occur at unexpected times.

• Blood Transfusion: In cases of serious blood loss, blood transfusion can be given to the pregnant woman.

• Uterine-preserving cesarean section: In case of placenta acreta, a cesarean section can be attempted by preserving the uterus, but especially in the case of percreta, the probability of uterine removal is at least 50%.

• Hysterectomy (removal of the uterus): It is a frequently applied last resort, especially in cases of advanced adhesion. This is the safest method that will not put the mother’s life at risk.

Follow-up and treatment are completely specific to the pregnant woman and her findings. The most important thing is to make an early diagnosis and make a good birth plan with appropriate follow-up. The point that should not be forgotten is that this surgery must be performed by an experienced perinatologist or gynecological oncologist.