Placenta Accreta Program

The Placenta Accreta Program in the Obstetrics Program in the Department of Obstetrics and Gynecology at Massachusetts General Hospital provides specialized, coordinated multidisciplinary care for pregnant women with placenta accreta and related placental complications.

Placenta accreta is also referred to as “abnormally adherent placenta,” “morbidly adherent placenta” or “abnormally invasive placenta.” It occurs when the placenta does not develop properly, putting a mother at risk for serious complications during delivery. While placenta accreta is extremely rare (affecting just 1 in 2500 pregnancies), it requires treatment from experienced clinicians and coordination among multiple specialties to ensure the best possible outcome for both the mother and her baby.

Risk Factors for Placenta Accreta

We do not know the specific cause of placenta accreta, but we do know that certain factors leave women at greater risk:

• Placenta previa (a placenta disorder in which the implanted placenta blocks the cervix)
• Prior C-sections
• Prior surgery of the uterus, including myomectomy or dilation and curettage (D&C)

Placenta accreta can be difficult to detect, so it cannot always be diagnosed. However, these risk factors raise suspicion that placenta accreta is present.

Diagnosing Placenta Accreta

If your provider thinks you may be at risk, he or she will use an ultrasound to look for abnormalities in your uterus that indicate placenta accreta. Your provider may also use an MRI to confirm a diagnosis of placenta accreta or aid in treatment planning.

While it is not always possible, early detection is helpful because it allows for careful treatment planning.

About Our Services: Specialized Treatment

The most important element for treatment of placenta accreta is advanced planning with a group of experienced specialists in a hospital with high surgical volumes. The Division of Maternal Fetal Medicine at Mass General created the Placenta Accreta Program, bringing together a multidisciplinary team of specialists to provide coordinated care and plan for the best possible outcomes for women with placenta accreta and related placental complications.

Women with placenta accreta often need to deliver early due to complications associated with the disorder, so a planned delivery is recommended. Most women will delivery between 34 and 36 weeks. A specialized neonatal intensive care team will also attend to care for your baby after delivery.

Importance of a Coordinated Team

A coordinated team effort is important because it helps prevent associated surgical complications, such as bladder injuries and hemorrhaging. Outcomes for patients with placenta accreta drastically improve when delivery is planned and all necessary resources are available for both the patient and her providers.

Our specialized planning ensures that we can assemble the proper team to facilitate a safe delivery for you and your baby and that all specialties work together for smooth cooperation from start to finish.

Our Maternal-Fetal Medicine specialists work with you before your delivery to provide optimal prenatal care so you know what to expect during delivery. When it’s time for delivery, our team works with you during and after to give you and your baby the best birth experience possible.

Learn more about Maternal-Fetal Medicine

Publications

The work of our coordinated team has been reviewed in The New England Journal of Medicine.