The pregnancy period is one of the crucial stages in a woman's life, as she may face many health conditions that may affect her health and put her life and the life of the fetus at risk. Among these cases, the problem of attached placenta. Many women wonder about the treatment of placenta accreta and how to deal with it to ensure a safe pregnancy. Therefore, we will answer all the questions Dalili Medical,  the condition of the attached placenta in this article.

**Is it possible to avoid placental adhesion?**

It is impossible to completely avoid placental adhesion, especially in cases of women who undergo multiple caesarean sections or suffer from placental abruption. However, early diagnosis can help reduce the complications associated with this condition.

**Do you consider the attached placenta to be a common condition? And what are the reasons?

Let's not reassure all pregnant women that the condition of placental adhesion affects only a small percentage of them. Today's Hadith is like a preventive warning, where we emphasize the importance of following up with the doctor throughout pregnancy to detect any possible risks and make sure that the placenta is in normal conditions or suffering from adhesions.

**Why do some women have attached placenta and not others?**

Most often, placenta accreta is found in women who have undergone previous surgeries in the uterus, such as removal of fibroid tumors or correction of the uterine wall. This condition can also develop as a result of repeated cesarean deliveries.

All previous surgical interventions lead to weakness of the uterine wall and leaving scars in the internal tissues. When the tissues of the placenta grow, they are related to the surgical scar, which leads to formations inside the muscular wall of the uterus instead of the external part as it happens in the normal placenta.

The mother's attached placenta can cause bleeding and loss of the fetus from the sixth to the ninth month of pregnancy, therefore, pregnant women should monitor their condition and perform ultrasound examinations periodically to confirm the health of the fetus and placenta.

Is it possible to see the attached placenta in al-Sonar?

 

Adherent placenta appears in two-dimensional sonar in the form of a low placenta, and to confirm its presence, a final examination must be performed using three-dimensional sonar. Diagnosis of placenta accreta and treatment depends on the doctor's experience and the ability to observe placenta reduction during routine ultrasound examination.

Are we the placenta?

 

The placenta is a temporary organ formed during pregnancy, where it is attached to the wall of the uterus and acts as a vital link for the fetus. the brain

In addition, the placenta plays a role in the mother's metabolism and providing the necessary energy reserves to support the healthy development of the fetus.

The placenta comes out after a short period of time after the birth of the child, usually between five and thirty minutes, in the process of identifying the baby after birth or the third stage of pregnancy.

Complications related to the placenta can occur, such as placental adhesions or separations, which may pose a risk to the health of both the mother and the child if not handled properly.

What are the types of attached placenta that require urgent surgical intervention?

Many patients wonder: "Does the treatment of the attached placenta differ according to the types?"

To answer this question, we should clarify that the attached placenta is divided into several types based on the extent of adhesion to the uterus, which is as follows:

. **Placenta accreta**

Placenta placenta attached to the muscles is the most common among pregnant women who suffer from this condition, as it represents about 75% of cases. This type occurs when the placenta attaches directly to the uterus without penetrating the uterine wall completely, which allows the placenta to separate without affecting the uterus.

. **Placenta increta** In this type, the tissues of the placenta completely overlap with the muscles of the uterus, but do not go beyond the uterine wall. This type represents about 15% of the total cases of attached placenta.

**Placenta percreta** In some cases, the placenta can penetrate the wall of the uterus and reach the neighboring organs, such as the bladder and intestines, which leads to damage. This type of placenta is considered the most dangerous, as it requires treatment. Complete removal of the uterus immediately after birth, with the safety of the mother and fetus.

Placenta previa usually settles in the upper part of the uterus before delivery, which makes it easier for the fetus to exit through the vagina. But in the case of placental abruption, the placenta is located in the lower part of the uterus and is connected to the cervix.

It is possible for the placenta to return to its normal state before the due date if it touches the cervix without scaring it.

But if the placenta overlaps with the cervix, it is divided into two types:

. **Partially placental abruption**: Where the placenta is partially attached to the cervix, it means that it covers only the cervix.

**Total placental abruption**: where the placenta is completely engrafted in the cervix, which leads to blockage of the vaginal opening and hinders natural childbirth. It is important to note that placental abruption, regardless of the types, can cause severe vaginal bleeding during pregnancy and childbirth. As a result, the doctor may decide to perform a caesarean section to protect the health of the mother and the fetus and avoid the risk of bleeding. The type of surgery depends on the diagnosis of the placenta before the caesarean section, in preparation for any possible complications, with the necessity of preparing the mother mentally and physically.

**When can the condition of the placenta attached to the uterus be diagnosed?**

It is possible to diagnose the condition of the attached placenta from the first months of pregnancy. Where the placenta is formed at the end of the monthThirdly, but the confirmation of the diagnosis starts from the fifth month (i.e. with the start of the week of the second week of the month). The doctor will continue to monitor the condition of the attached placenta using three- or four-dimensional ultrasound imaging until the delivery date, which is usually at the end of the eighth month or the beginning of the ninth month (between the 35th and 36th weeks of pregnancy).

How does the attached placenta occur?

The placenta plays an important role in providing food and oxygen to the fetus during pregnancy, and it is also responsible for the release of many hormones that help stabilize and maintain pregnancy. When the due date of delivery approaches, the placenta separates from the wall of the uterus after the baby is born. However, it sometimes happens that the placenta remains attached to the walls of the uterus after birth, and in this case, it is classified into three types based on the depth of adhesion to the uterus, namely:

The first type "Placenta Accreta": It is considered the most common, where the placenta adheres to the uterine wall without affecting the muscles.

The second type "Placenta Increta": It is observed in about 15% of the cases, where the placenta is deeply indented and connected to the muscles of the uterus.

The third type "Placenta Percreta": appears in about 5% of cases, and it is a very dangerous type, where the placenta continues to grow in the wall of the uterus until it penetrates and affects other organs such as the bladder and intestines.

What is the function of the placenta?

 

The placenta is removed vitally during pregnancy. Below are the most important functions:

. **Providing nutrients and oxygen**: Through the umbilical cord, the placenta transports essential nutrients and oxygen from the mother to the fetus, which ensures healthy growth and development.

. **Removal of waste products**: The function of the placenta is to eliminate waste products, such as carbon dioxide, from the tail of the fetus, where it transports these waste products to the mother's bloodstream for elimination.

. **Production of hormones**: The placenta produces essential hormones to maintain pregnancy health, such as estrogen, progesterone, lactogen, and human placental hormone (HCG).

. **Immune protection**: transfer of placental antibodies from the mother to the fetus before birth, which enhances immunity during the first months of life.

What is the difference between the advanced placenta and the attached placenta?

God created the placenta to facilitate the nutrition of the fetus and provide it with sufficient oxygen during pregnancy. The placenta is attached to the endometrium without sticking to the internal muscles, which allows it to detach easily during the birth process without causing any problems for the mother or the fetus. However, the placenta may face some problems, especially in the second half of pregnancy, as a result of risk factors such as the advancing age of the mother, which leads to the growth of the placenta in an abnormal place and leads to serious complications.

The forms of abnormal growth of the placenta include the following:

The placenta usually grows in the upper part of the womb, where it is connected to the fetus, and when its functions are completed with the advance of pregnancy, it allows the fetus to pass through the vagina during natural childbirth, and then it separates easily in preparation for discharge. In the case of advanced placenta, the placenta grows in the lower part of the uterus near the cervix, and the degree of coverage of the cervix varies, as it can be partially or completely covered.

This problem leads to the occurrence of vaginal bleeding in the last months of pregnancy, which causes difficulty in natural childbirth and calls for the treatment of placenta previa during this period and during the birth process, in order to avoid the loss of life or the loss of embryos.

**The attached placenta** The problem of the attached placenta occurs in some cases when the roots of the placenta tissue extend to penetrate the endometrium and the muscle layer. In this case, it is not possible during childbirth except during a surgical procedure to remove the uterus, in order to avoid the mother's exposure to blood that may lead to a sudden drop in blood circulation and then death - God willing.

**How ​​to diagnose the attached placenta**

It is possible to diagnose placenta accreta during ultrasound examination, which may occur unexpectedly during routine examinations during pregnancy.

Although there are no obvious symptoms of placenta accreta during pregnancy, some women may notice bleeding during the last three months, which may contribute to the diagnosis and treatment of the condition.

Re-diagnosis is done before determining the date of caesarean delivery to confirm the type of placental adhesion and to make an approximate plan for the operation and the necessary steps.

What are the reasons that lead to placental adhesion?

It is believed that the following factors increase the probability of placental adhesion:

- **Repeated caesarean births:** Multiple caesarean births can lead to uterine rupture, which increases the risk of placental abruption, which occurs in about 60% of cases.

- **Uterine injuries:** The scarring caused by a previous injury in the uterus, such as the removal of fibroids, can lead to placental adhesion.

Placenta al-menzaha: Occurs when the placenta is near the cervix or upper part, either partially or completely.

Mother's age: Placental adhesions are considered to be more common in women over the age of 35.

**Al-Mushima al-Muttasqa: Is it dangerous?**

 

Adherent placenta can cause some complications, including:

- **Acute vaginal bleeding:** The length of the attached placenta leads to severe bleeding after childbirth, which exposes women to the risk of lung and kidney failure, and threatens their lives.

- **Early birth:** Early labor starts as a result of placental adhesion.

- **Lack of Fertility:** The length of the attached placenta affects the uterus, which leads to exhaustion and loss of the ability to conceive.

- Damage to the surrounding organs: If the adhesions of the placenta continue, the organs adjacent to the uterus may be damaged.

**How ​​to treat the attached placenta after caesarean section?**

Most of the attempts of the placenta chapter to protect the woman from the risk of bleeding include atheism, where the placenta is firmly attached to the endometrium and reaches the bladder in advanced cases. No attempt at chaptersHeight leads to loss of large amounts of blood.

Adherent placenta can be treated after caesarean section during an incision in the abdomen and finally in the uterus to remove the fetus. After giving birth, the doctor removes the uterus and placenta. In some rare cases, the doctor may try to avoid the removal of the uterus by occluding the uterine artery and connecting other arteries to prevent blood flow to the uterus, which helps to reduce the possibility of bleeding. High doses of methotrexate can also be used for placental abruption. However, this procedure may result in some complications, such as:

Acute vaginal bleeding.

Contagion

The possible need to perform hysterectomy in the future.

Increased probability of adhesions in the placenta in the event of another pregnancy.

** Conditions more prone to placenta accreta **

It is related to the cases that may be candidates for placenta accreta due to the following factors:

- All women suffer from abnormalities in the lining of the uterus.

- Women who have undergone previous caesarean section or other injuries in the uterus.

- Prevalence of life of pregnant women.

- An increase in the number of pregnancies and births.

- Abnormal position of the fetus (recumbent position), where the back of the fetus is at the cervix instead of the head.

There are also different types of placenta accreta according to the types and the complications.

**Symptoms of attached placenta**
Usually, the mother does not show any obvious symptoms as a result of the attached placenta during the months of pregnancy, and it is often discovered during the ultrasound examination. However, some women suffer from vaginal bleeding in the last third of pregnancy. As the pregnancy progresses and the placenta adheres to the uterus, it becomes difficult for the seasons during the birth process, which may lead to serious complications for both the mother and the fetus.

**Dangers of the placenta attached to the mother**
- The need to perform a caesarean section, which means the impossibility of a natural birth.

- Acute lens exposure during childbirth.

And if the doctor faces difficulty in the placenta during the caesarean delivery, he may be forced to remove the uterus to control the bleeding, while providing blood transfusion to the mother during the operation to preserve her life.

Dangers of the placenta attached to the fetus:

The child faces the risk of premature birth, which may lead to incomplete development of some organs, such as the lungs.

Also, the child can be affected by the bleeding that occurs to the mother in the last trimester of pregnancy, which leads to a lack of oxygen and nutrients that reach it during pregnancy, which exposes it to serious complications.

Does the attached placenta cause death?

The attached placenta is considered the most dangerous problem that may be faced by the placenta, as it poses a threat to the life of the mother and the fetus. Therefore, many women wonder: Can the dangers of the attached placenta lead to death?

In fact, the length of the attached placenta leads to the loss of the mother's life if the obstetrician and gynecologist does not intervene at the right time when the problem is discovered. Usually, this intervention includes the following:

- Periodic follow-up of the state of the mother during the remaining period of my pregnancy during magnetic resonance imaging and ultrasound to determine the extent of placental cell invasion in the uterus.

- Carrying out the birth process in a hospital equipped with a blood bank and intensive care unit to provide the necessary care for the mother during childbirth and afterwards.

If the mother ignores the doctor's advice and neglects periodic follow-ups, she may experience severe bleeding during childbirth, which may lead to a sharp decrease in blood circulation and pose a threat to her life.

**Preparations before the treatment of the attached placenta**
When confirming the diagnosis of placenta accreta, the woman is subjected to a number of precise preventive preparations to avoid possible complications during the treatment and ensure the safety of the fetus.

These preparations include the following:

- Performing blood tests to check the level of red blood cells.

- Carrying out liver and kidney function tests.

- Performing a four-dimensional sonar to confirm the health of the fetus.

- Equipping the tail bags of the woman's tail in anticipation of bleeding after childbirth.

- Avoid taking any medicine without consulting your doctor.

- Making an appointment with a specialist surgeon in the urinary tract in case of placental bladder penetration.

**Interaction with the attached placenta and uterine excision during childbirth**

As the date of caesarean delivery approaches, doctors begin to adopt a group of preventive measures to deal with the possible complications resulting from the placenta accreta and the removal of the uterus after the birth of the fetus, including these measures:

- Conducting comprehensive medical examinations for the patient and providing immediate treatment if she is suffering from anemia.

- Equipping the tail bags of my mother's body in anticipation of the bleeding that may occur after childbirth and abortion.

- Forming an integrated medical team including obstetrics and gynecology and urology consultants to intervene when the placenta is connected to the bladder.

- Using an experienced anesthesiologist to ensure proper anesthesia of the patient and the support of the medical team.

**we after surgery**

After the surgical procedure, the wife needs additional health care and continuous follow-up with the doctor until she recovers completely from the effects of the surgery. Also, she needs psychological support, because the surgery of the uterus removal leaves me with deep feelings of sadness in the woman.

**How ​​can I avoid placental adhesion?**

It is impossible to predict placental adhesion situations or accidents, as there are no clear reasons through which preventive measures can be taken. The length of placenta accreta appears in some women who have undergone a previous caesarean section, due to the scars caused by surgery on the wall of the uterus. However, this is not considered as a general rule, as there are many other cases that have been subjected to surgical procedures and the subsequent attachment of the placenta.

**Treatment of attached placenta due to caesarean wound: When is it done?**

Doctors start treating the placenta attached to the caesarean section before the expected date of delivery, in order to avoid contractions in the uterus and the onset of labor, as this may lead to the danger of pregnancy.The evil of atheism Therefore, it is recommended to perform a caesarean section between the 34th and 37th weeks of pregnancy, after giving the lady corticosteroid injections to promote the development of the fetal lungs. And if the lady has vaginal bleeding during the last trimester of pregnancy, the doctor may recommend that she be admitted to the hospital for care until the delivery date.