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Placenta Accreta Spectrum Treatment

Specialist diagnosis and management of placenta accreta spectrum disorders at Pristyn Care. Our expert surgical team provides planned caesarean and hysterectomy with full multidisciplinary support to protect maternal health.

Specialist diagnosis and management of placenta accreta spectrum disorders at Pristyn Care. Our ... Read More

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    Dr. Kiran Dua - A gynaecologist for Endometriosis

    Dr. Kiran Dua

    MBBS, MD-Obs & Gynae
    48 Yrs.Exp.

    5.0/5

    48 Years Experience

    location icon Pristyn Care Elantis Hospital, Lajpat Nagar, Delhi
    Call Us
    080-6542-3711
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    Dr. Krishan Kapur - A gynaecologist for Endometriosis

    Dr. Krishan Kapur

    MBBS, MD-Obs & Gynae
    42 Yrs.Exp.

    4.5/5

    42 Years Experience

    location icon Pristyn Care Elantis Hospital, Lajpat Nagar, Delhi
    Call Us
    080-6962-5908
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    Dr. Uma Challa - A gynaecologist for Endometriosis

    Dr. Uma Challa

    MBBS, MD-Obs & Gynae
    42 Yrs.Exp.

    5.0/5

    42 Years Experience

    location icon 7-1-71/A/1, Dharam Karan Rd, ShivBagh, Ameerpet, Hyderabad, Telangana 500016
    Call Us
    080-6542-3712
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    Dr. Neeta Mishra - A gynaecologist for Endometriosis

    Dr. Neeta Mishra

    MBBS, MD-Obs & Gynae
    40 Yrs.Exp.

    5.0/5

    40 Years Experience

    location icon Pristyn Care Elantis, Ring Road, Lajpat Nagar
    Call Us
    080-6542-3711

Placenta Accreta

Placenta accreta spectrum (PAS) disorders occur when the placenta abnormally implants into or through the uterine wall, failing to separate after delivery. The spectrum includes accreta (superficial), increta (myometrial invasion), and percreta (full wall invasion). PAS is associated with severe haemorrhage risk at delivery. Pristyn Care offers specialist multidisciplinary management including planned caesarean hysterectomy, ensuring the safest outcomes for affected mothers.

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Symptoms

Placenta accreta spectrum may present with:

  • Often asymptomatic until delivery
  • Vaginal bleeding in the second or third trimester
  • Abnormal placental attachment identified on ultrasound
  • Difficulty separating the placenta after birth
  • Severe haemorrhage immediately after delivery
  • Signs of placenta praevia on antenatal scan

Causes

Risk factors and causes of placenta accreta spectrum include:

  • Previous caesarean section (most significant risk factor)
  • Prior uterine surgery including myomectomy or curettage
  • Placenta praevia overlying a previous caesarean scar
  • Advanced maternal age over 35 years
  • Multiple previous pregnancies (grand multiparity)
  • Uterine abnormalities or fibroids
  • Asherman syndrome (intrauterine adhesions)

Types of Placenta Accreta Spectrum

The spectrum includes three grades of severity:

  • Placenta Accreta – superficial attachment to the uterine muscle without deep invasion
  • Placenta Increta – invasion into the myometrium (uterine muscle)
  • Placenta Percreta – complete invasion through the uterine wall into adjacent organs such as bladder

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Risk Factors

Key risk factors for placenta accreta spectrum include:

  • History of one or more caesarean sections
  • Placenta praevia overlying a caesarean scar
  • Prior uterine surgery or curettage
  • Advanced maternal age
  • High parity (four or more previous pregnancies)
  • Asherman syndrome or intrauterine adhesions

Who Is at Risk?

Women with previous caesarean sections who have a low-lying placenta in the current pregnancy are at the highest risk. Risk increases significantly with each additional caesarean scar. Women with prior uterine surgery, advanced maternal age, or Asherman syndrome are also at increased risk.

Diagnosis

Diagnosis of placenta accreta spectrum involves:

  • Routine antenatal ultrasound with colour Doppler assessment
  • MRI pelvis for detailed evaluation of invasion depth and organ involvement
  • Assessment of placenta location relative to uterine scar
  • Cystoscopy if bladder involvement is suspected
  • Specialist maternal-fetal medicine consultation and multidisciplinary team planning

Treatment Options

The primary treatment is planned caesarean delivery followed by hysterectomy (caesarean hysterectomy) to prevent life-threatening haemorrhage. This must be planned by a specialist multidisciplinary team including obstetrics, urology, blood bank, and intensive care. Conservative uterine-preserving management may be attempted in selected cases where future fertility is strongly desired.

Caesarean Hysterectomy Procedure

Planned caesarean hysterectomy for placenta accreta spectrum involves:

  • Specialist multidisciplinary team including maternal-fetal medicine, urology, anaesthesia, and blood bank
  • Pre-operative uterine artery embolisation may be performed to reduce blood loss
  • Planned delivery at 34-36 weeks after corticosteroids for fetal lung maturity
  • Vertical midline incision for optimal surgical access
  • Uterine incision away from the placenta to deliver the baby safely
  • Hysterectomy performed with the placenta in situ if firmly adherent
  • Cell salvage, large bore IV access, and blood products on immediate standby

This planned, multidisciplinary approach significantly reduces the risk of catastrophic haemorrhage and maternal mortality.

After the Surgery

Post-operative care after caesarean hysterectomy includes:

  • Intensive care unit admission for close post-operative monitoring
  • Blood transfusion and haematological support as required
  • Urinary catheter monitoring for bladder function
  • VTE prophylaxis and prophylactic antibiotic therapy
  • Neonatal team attendance for preterm baby care
  • Psychological counselling regarding loss of fertility
  • Hospital stay of 5-10 days depending on recovery

Possible Complications of PAS Surgery

Possible complications of placenta accreta spectrum management include:

  • Massive obstetric haemorrhage requiring blood transfusion
  • Ureteric or bladder injury, particularly in percreta
  • Bowel injury in extensive placenta percreta cases
  • Disseminated intravascular coagulation (DIC)
  • Intensive care admission requirement
  • Wound complications and infection
  • Loss of fertility following hysterectomy
  • Psychological impact related to loss of uterus

Frequently Asked Questions (FAQs)

What is placenta accreta spectrum disorder?

Placenta accreta spectrum refers to conditions where the placenta abnormally attaches to or invades the uterine wall, making it unable to separate normally after delivery and causing severe haemorrhage risk.

What increases the risk of placenta accreta?

The most significant risk factor is having had one or more previous caesarean sections, especially when combined with a low-lying placenta in the current pregnancy. Risk increases with each additional caesarean scar.

Can placenta accreta be detected before delivery?

Yes, it can often be suspected on routine antenatal ultrasound with Doppler assessment. MRI provides further confirmation. Early diagnosis allows proper planning of a safe, specialist-led delivery at a tertiary centre.

What is the treatment for placenta accreta?

The standard treatment is planned caesarean hysterectomy performed by a specialist multidisciplinary team. Conservative uterine-preserving management may be considered in carefully selected cases to preserve fertility.

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Medically Reviewed By
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Dr. Kiran Dua
MBBS, MD-Obs & Gynae
48 Years Experience Overall
Last Updated : April 29, 2026

What Our Patients Say

  • ME

    Mehak, 25 Yrs

    verified
    5/5

    My Endometriosis treatment was good and recovery seems great. Would like to thank dr radhikha G for it. She is really help full

    City : Chennai
    Treated by : Dr. Radhika G
  • HJ

    Hansika Jindal

    verified
    5/5

    One day, my friend Sneha told me she had been experiencing pain for two to three months, which was often much worse than normal period cramps. I suggested she consult a gynecologist and start treatment, and she is now well.

    City : Hyderabad
  • MI

    Meera Iyer

    verified
    5/5

    Endometriosis was ruining my daily life. The treatment suggested has given me so much relief. Can’t believe I can go through an entire month now without that unbearable pain.

    City : Hyderabad
  • NB

    Nisha Bhandari

    verified
    5/5

    Endometriosis treatment was handled very carefully. I used to think the pain was normal, but now I know it’s not. Life feels so much lighter.

    City : Hyderabad
  • SH

    Shalini, 27 Yrs

    verified
    5/5

    The best thing about she is an excellent and skilled surgeon she gave me a thorough explanation in a calm manner that i could understand, which nearly made the whole stressful situation enjoyable.

    City : Delhi
    Treated by : Dr. Nidhi Moda
  • PO

    Pooja, 38 Yrs

    verified
    5/5

    Recovery was smooth thanks to the doctor.

    City : Delhi
    Treated by : Dr. Kiran Dua