Due to our success in treating the most severe cases of morbidly adherent placenta, Texas Children’s Pavilion for Women continues to attract numerous patients from across the country. With the rise of caesarean births in the U.S., this potentially life-threatening condition is becoming more common among pregnant women.
Morbidly adherent placenta – known as placenta accreta, increta or percreta, depending on the depth of uterine invasion – occurs when the placenta and its blood vessels grow deeply into the wall of the uterus and is unable to detach after childbirth. Women who have had prior caesarean sections (C-sections) or other uterine surgeries are more at risk for this pregnancy complication since the placenta latches on to the surgical scar too firmly. About 5 to 7 percent of women die due to massive hemorrhage.
“The number of women with morbidly adherent placenta that we care for is rapidly escalating as our outcomes continue to attract a growing number of referrals,” said Texas Children’s OB-GYN Chief Dr. Michael Belfort, a world-renowned placenta accreta expert and founder of the Morbidly Adherent Placenta Program at Baylor College of Medicine. “Our success is rooted in our ability to work as a team.”
Women with morbidly adherent placenta receive multidisciplinary care from a diverse group of specialists representing maternal-fetal medicine, gynecologic oncology, anesthesiology, urology, neonatology, radiology and blood bank services.
“Our multidisciplinary team works closely with the hospital’s blood bank to ensure adequate supply of blood products is available for surgery and to help manage transfusions,” said Texas Children’s Maternal-Fetal Medicine specialist Dr. Karin Fox. “We rely on our anesthesiology team to administer blood and draw labs to ensure electrolytes remain stable in addition to keeping the patient comfortable. Urologists provide expertise when the placenta embeds itself into the urinary system.”
The approach that gynecologic oncology surgeons use to remove uterine cancer inspired the technique used to treat placenta percreta since the abnormal placenta acts like a cancer invading the outside of where it is supposed to be growing.
“We take a wider approach when we perform a hysterectomy to reduce the potential for blood loss,” said Texas Children’s gynecologic oncologist and surgeon Dr. Concepcion Diaz-Arrastia. “We remove the uterus and cervix in a modified radical hysterectomy along with a small amount of the tissue that attaches the uterus to the pelvis as if it were cancerous.”
Khadajah Winchester credits the Pavilion for Women’s highly skilled team of physicians who meticulously prepared and planned for her emergency surgery. She was airlifted from a hospital in Alexandria, Louisiana to the Pavilion for Women.
Winchester – who had two previous caesarean deliveries – had placenta percreta where the placenta invaded part of her bladder. Physicians made an incision high on Winchester’s uterus to avoid touching her placenta. Despite minimal bleeding during the actual delivery of her 6-pound 7-ounce baby girl Brooklyn, Winchester began bleeding profusely from the numerous vessels that had fed her invasive placenta and required a 25-pint massive blood transfusion.
“I hardly had blood pumping through my veins and if I had not gone to the Pavilion for Women, I would have died,” Winchester said. “Hospitals in smaller communities don’t carry the large volume of blood that I needed to survive.”
The Pavilion for Women – world renowned for its comprehensive, multidisciplinary care and focus on high-risk pregnancies – has treated 27 cases of placenta accreta in the last 12 months.
“Patients with risk factors for placenta accreta should consult with specialists early – ideally by 24 to 28 weeks of pregnancy,” said Texas Children’s Maternal-Fetal specialist Dr. Alireza Shamshirsaz. “Early diagnosis prior to delivery is crucial to allow time for planning and preparation to enhance the best possible outcomes for mother and baby.”
Click here for more information about Baylor’s Morbidly Adherent Placenta Program at the Pavilion for Women.