Division of Maternal-Fetal Medicine
The Division of Maternal-Fetal Medicine offer expert patient care, research programs, and education and training opportunities.
Placental Disorders in Pregnancy
Care for patients with cesarean scar, placenta previa, accreta, increta, percreta and more.
Care for Disorders of the Placenta
The New England Center for Placental Disorders (NECPD) at Beth Israel Deaconess Medical Center (BIDMC) is an internationally-recognized multidisciplinary program that offers comprehensive and compassionate care for patients with high-risk pregnancies affected by the full spectrum of placental disorders (cesarean scar pregnancy, previa, accreta, increta, and percreta). In addition to providing advanced diagnosis and highly specialized treatment, our team of doctors, scientists, and researchers is actively developing innovative approaches to care.
Placental disorders are uncommon but can be serious. That’s why it’s important to have a team of experts by your side. Our specialists work closely with your obstetrician and other providers to make sure your care is seamless and personalized. With this team-based approach, you will have the support of multiple experts, each focused on helping you, your family, and your baby achieve the best possible outcome.
Understanding Placental Disorders
The placenta is an organ that grows inside your uterus during pregnancy. It provides your baby with oxygen and nutrients and removes waste, all through the umbilical cord.
Usually, the placenta attaches to the upper part of the uterus. Sometimes, however, the placenta implants in the wrong location or attaches too deeply into the uterine wall, resulting in a variety of placental disorders.
In most cases, prenatal care teams diagnose placental disorders using ultrasound in the second trimester, typically around 18 to 20 weeks into a pregnancy. However, sometimes, placental disorders can be diagnosed even earlier.
Risk Factors for Placental Disorders
These and other factors that can increase your risk for developing a placental disorder:
- Previous uterine surgery
- Placenta previa
- Maternal age over 35 years
- Multiparity
- In vitro fertilization (IVF)
- Twins or higher order multiple gestation
- Asherman syndrome
- Working with your doctor to manage any health conditions, such as high blood pressure
- Not smoking or using drugs
- Visiting your health care provider regularly throughout the pregnancy
Comprehensive, Compassionate Care
Being diagnosed with a placental disorder can be scary and stressful. A placental disorder can cause bleeding and other complications during pregnancy. Our experts work together to diagnose the condition and create a personalized plan to care for you and your baby.
We are here to support you every step of the way with medical and surgical care, in addition to the personal support you need to stay physically and emotionally well throughout your pregnancy.
Research Offers Emerging Treatment Options
BIDMC researchers regularly conduct research on placental disorders. Depending on your situation and current studies, you may benefit from joining a clinical trial. Your MFM doctor will let you know if you may be a candidate for current research.
More About Placental Disorders Care
Placenta Previa
Placenta previa occurs when the placenta covers some or all of the cervix. If you have placenta previa early in pregnancy, it usually isn't a problem. However, it can cause serious bleeding and other complications if it persists later in pregnancy.
Symptoms and Diagnosis
Placenta previa might cause bleeding during pregnancy and during delivery.
In most cases, doctors diagnose placenta previa after a routine ultrasound at around 18-20 weeks. Placenta previa may also be diagnosed for the first time after a patient has painless, bright red vaginal bleeding during the second half of pregnancy. Your obstetrics team will use ultrasound to confirm the diagnosis.
Treatment
Placenta previa diagnosed early in pregnancy often resolves on its own. As the uterus grows, the distance between the cervix and the placenta also often grows. If the placenta previa doesn’t resolve by the end of the pregnancy, your care team will recommend cesarean delivery, usually around 36-37 weeks.
Placental Accreta Spectrum (Accreta, Increta & Percreta)
When the placenta attaches too deeply into the uterine wall, it is called placenta accreta, increta or percreta, depending on how deeply it attaches. These conditions can lead to bleeding and other complications.
If you have one of these conditions, your care team will usually deliver your baby before your due date via cesarean section. Because the placenta may not separate safely from the uterus after delivery, a hysterectomy (surgery to remove the uterus) may also be necessary to protect your health.
Treatment for Placenta Accreta Spectrum
If you have one of these conditions, your obstetrics care will transfer to a team of specialists with a specific focus on placental disorders. Our team includes specialists in these areas:
- Maternal-fetal medicine
- Obstetrics anesthesia
- Blood transfusion
- Urology
- Social Work
- Gynecology oncology
- Interventional radiology
- Critical care
- Nursing
- Neonatology
At the time of delivery, you’ll most likely need to have a hysterectomy.
