The Rising Tide of Placenta Accreta: A Silent Threat to Maternal Health
A growing campaign, spearheaded by Amisha Adhia, is shining a light on critical gaps in NHS care surrounding placenta accreta spectrum (PAS), a potentially life-threatening childbirth complication. Adhia’s personal experience – where five hospitals initially failed to diagnose her condition – underscores a worrying trend: increasing rates of PAS coupled with inconsistent diagnosis and management across the UK’s healthcare system.
Understanding Placenta Accreta: A Deepening Concern
Placenta accreta occurs when the placenta implants too deeply into the uterine wall. This can lead to severe bleeding during or after delivery, potentially requiring emergency hysterectomy or resulting in maternal death. The condition is becoming more prevalent, directly linked to the rising number of Cesarean sections and IVF treatments. Currently, between one in 300 and one in 2,000 women develop placenta accreta, but experts warn these numbers are climbing.
The Impact of Rising C-Section Rates
England now sees more babies born via C-section (45%) than through natural vaginal birth (44%). This shift, while offering benefits in certain situations, directly contributes to the increased incidence of PAS. The Royal College of Obstetricians and Gynaecologists (RCOG) acknowledges this correlation and anticipates further increases in PAS rates as C-section numbers continue to rise.
Diagnostic Delays and the Call for Specialist Care
Adhia’s story isn’t isolated. Approximately 40 women have contacted the couple behind the Action for Accreta campaign, sharing similar experiences of delayed diagnosis and inadequate care. The core issue appears to be a lack of specialized expertise within NHS maternity units. Not all hospitals have dedicated PAS specialists, leading to subtle warning signs being overlooked.
“I was reassured into danger,” Adhia recounts. “I was carrying a condition that could have killed us both. I felt unheard.” Her case, ultimately resolved thanks to the intervention of Dr. Chineze Otigbah, a consultant obstetrician, highlights the critical role of specialist knowledge in managing this complex condition.
Data Gaps and the Require for National Surveillance
A significant obstacle to addressing the PAS crisis is the lack of comprehensive data. The NHS currently does not systematically record cases of placenta accreta or associated complications. This absence of national surveillance hinders efforts to understand the true scale of the problem and implement targeted interventions. Studies from the US and Israel suggest the prevalence could be as high as one in 111 pregnancies, a figure significantly higher than current UK estimates.
The Role of Updated Guidance and Ongoing Research
The RCOG is currently updating its guidance on managing placenta accreta and placenta praevia, with new recommendations expected later in 2026. This updated guidance is expected to address diagnosis and management of atypical forms of PAS, as well as emphasize the importance of early identification through pregnancy scans and specialist referral. The updated guidelines will also address the increasing rates of both conditions due to rising C-sections, higher maternal age, and increased use of assisted reproductive technologies.
What Does the Future Hold? Potential Trends
Several trends are likely to shape the future of placenta accreta management:
- Increased Focus on Risk Stratification: More sophisticated risk assessment tools will be used to identify women at higher risk of developing PAS, allowing for proactive monitoring and specialist referral.
- Expansion of Specialist Centers: The establishment of regional PAS centers of excellence will ensure that all women have access to expert care, regardless of their location.
- Advanced Imaging Techniques: Improved ultrasound and MRI techniques will enhance the accuracy of diagnosis and allow for better surgical planning.
- Personalized Management Strategies: Treatment plans will be tailored to the individual patient’s risk factors and the severity of their condition.
- National Data Registry: The implementation of a national registry to track PAS cases and outcomes will provide valuable data for research and quality improvement.
Frequently Asked Questions (FAQ)
- What are the main risk factors for placenta accreta?
- Previous Cesarean section, IVF treatment, and multiple pregnancies are the primary risk factors.
- What are the symptoms of placenta accreta?
- Often, there are no noticeable symptoms. However, vaginal bleeding in the third trimester can be a sign.
- Is placenta accreta always life-threatening?
- While potentially life-threatening, with early diagnosis and appropriate management, serious complications can often be avoided.
- What is the role of the RCOG in addressing this issue?
- The RCOG is updating its guidelines to improve diagnosis and management of placenta accreta and related conditions.
Do you have experience with placenta accreta or know someone who does? Share your story in the comments below to help raise awareness and support others.
