With the increase of caesarean sections, a severe medical condition, morbidly adherent placenta, is becoming more common in pregnant women, but Baylor College of Medicine doctors’ unique approach to the treatment is proving beneficial to patients.
When a caesarean section is performed it leaves a scar, not only on the skin but also on the uterus. A morbidly adherent placenta occurs when the placenta attaches and imbeds inside the previous caesarean section scar and muscle. In some cases the placenta will grow outside of the uterus and attach to surrounding areas, like the bladder or abdominal muscles.
This is a dangerous condition that may lead to a hemorrhage and may even be fatal. The death rate associated with this is around 4 to 8 percent.
It is possible to know ahead of time if the morbidly adherent placenta exists during pregnancy. Ultrasounds performed around 18 to 28 weeks typically show if this condition is present in a patient. An MRI also can provide a look at the uterus. However, neither method is 100 percent accurate.
“Diagnosis before delivery is key to allow time for planning and preparation,” said Dr. Karin Fox, assistant professor of maternal-fetal medicine in the Department of Obstetrics and Gynecology at Baylor.
Baylor doctors have developed a checklist to help identify women who are at risk. They also make identifying and treating morbidly adherent placenta a team effort by including those in gynecologic oncology, urology, anesthesiology and the blood bank.
“We see more success when working as a team,” said Fox. “We are actively researching this condition to develop ways to provide the most comprehensive treatment.”
Additionally, they are seeing success by taking a wide surgical approach when cutting around the placenta, says Dr. Concepcion Diaz-Arrastia, associate professor of gynecologic oncology in the Department of Obstetrics and Gynecology at Baylor. This wide approach helps limit the blood loss in the patient.
In the last 12 months Baylor doctors working at the Texas Children’s Pavilion for Women, where both Fox and Diaz-Arrastia see patients, have seen 27 cases of morbidly adherent placenta. Patients from across the United States are being sent here for treatment once they have been diagnosed with a morbidly adherent placenta.