According to the Royal College of Obstetricians and Gynecologists (GBR), complications of pregnancy such as placenta praevia or accreta, when the placenta is poorly implanted, are increasing due to increased use of PMA and caesarean. The placenta accreta thus affects one woman out of 2,000 on average, but this proportion affects one woman out of 300 among women who have had several cesareans, ensures the CJR.
However, if it is not diagnosed, this placental anomaly can lead to hemorrhage during delivery, or even emergency hysterectomy. However, a simple routine ultrasound scan during pregnancy would detect this type of placental abnormality, and then refer patients to specialized care units.
To help women understand these abnormalities and the resulting complications, the UK CJOC has developed a guide. In particular, it is stated that "placenta accreta is more common in women with placenta previa who have had one or more caesarean section, but this can also happen if they have had another surgery or if has a uterine abnormality, such as fibroids or a bicornous uterus. It is [also] more common if you are older (over 35) or if you have been on fertility treatment, especially in vitro fertilization (IVF), "say gynecologists.
In addition, placenta previa occurs when the placenta becomes too low and can obstruct the opening of the uterus during pregnancy. In this case, a caesarean section should be considered.
"We hope that this update will help health professionals in discussions with women and their partners who are considering assisted procreation, especially IVF, or a cesarean section of comfort," said Professor Eric Jauniaux, author of the CJRG guidelines as these are the two risk factors that may increase the incidence of placental abnormalities. Note that such care recommendations have not yet been published in France.
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