A Guide for You and Your Family
We're here to help you understand your diagnosis and the care plan ahead.
This presentation explains what you need to know in plain language.
What is this?
The placenta (the organ that feeds your baby) sometimes attaches too deeply to the wall of your uterus. We call this Placenta Accreta Spectrum, or PAS.
Normally, the placenta sits on the uterus lining like a sticker on paper. With PAS, it grows into the muscle wall like roots into soil.
Why does it matter?
The placenta may not separate properly after delivery. This can cause heavy bleeding. Early detection lets us plan for a safe delivery.
What is this?
PAS usually happens when the uterus lining has a scar or thin area. The placenta can attach more deeply in these spots.
Previous cesarean birth, placenta previa (placenta over cervix), prior uterine surgery, multiple pregnancies
You didn't cause this. PAS happens because of how the placenta grows, not because of anything you did.
Remember: Most people with risk factors do NOT develop PAS. When it does occur, careful planning leads to good outcomes.
What happens next?
We'll use imaging to confirm the diagnosis and see exactly where the placenta is attached. This helps us create your personalized care plan.
What is this?
We use ultrasound and sometimes MRI to look at where the placenta is attached and how deeply it has grown.
Doppler ultrasound uses sound waves to show blood flow. It helps us see the abnormal blood vessels that feed the placenta.
Why does it matter?
Finding PAS before delivery is crucial. It allows us to plan surgery with the right team, in the right place, at the right time. This planning reduces your risk of complications.
What is this?
Sometimes we recommend an MRI. This gives us a more detailed picture, especially if the placenta is in the back of your uterus or if we need to see nearby organs.
Shows placenta depth more clearly. Helps us see if bladder or bowel is involved. Better view of the back of the uterus.
MRI uses magnets, not radiation. It's safe during pregnancy and doesn't hurt.
What happens next?
We'll schedule regular ultrasounds throughout your pregnancy. These check-ups help us watch how the placenta grows and adjust your delivery plan if needed.
You're being monitored closely. Frequent imaging might feel overwhelming, but each scan helps us give you the safest care possible.
What is this?
PAS requires specialists from different fields working together. You'll meet several doctors who each bring specific expertise to your care.
Why does it matter?
This team approach means experts are prepared for any situation. Everyone knows the plan before surgery starts.
What can I do?
Meet with team members before delivery. Ask questions. Bring a support person to appointments to help remember information.
What is this?
We'll schedule a cesarean delivery before your due date, usually between 34 and 37 weeks. The exact timing depends on your specific situation.
Delivering before labor starts reduces the risk of emergency surgery and bleeding. We balance this with giving your baby time to develop.
What happens next?
You'll be admitted to a hospital with advanced surgical facilities and a Level III or IV neonatal intensive care unit.
What is this?
The surgery will likely take longer than a standard cesarean. The safest approach is often to deliver your baby and then remove the uterus with the placenta still attached.
Removing the uterus (hysterectomy) prevents the life-threatening bleeding that can happen if we try to remove the placenta separately.
Once delivered, your baby goes to the NICU team. You'll see your baby as soon as it's safe for both of you.
We have multiple strategies ready to control bleeding:
This team has trained for this. Complex cases like yours are what these specialists do. The plan is made with your safety as the top priority.
What is this?
Recovery takes longer than a standard cesarean because the surgery is more extensive. Most people stay in the hospital for 3 to 5 days.
What can I do?
Arrange help at home before delivery. Accept support from family and friends. Be patient with your body as it heals.
What can I do?
You play an important role in your care. Here's how you can be an active partner:
Your voice matters. This is your body and your baby. We make the plan together, with your values guiding our recommendations.
Bring this list to your appointments. There are no wrong questions.
You've got this. Having PAS is serious, but you're in expert hands. The planning we do together gives you and your baby the best possible outcome.
We're with you every step of the way.