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Preparing for your appointment
By Mayo Clinic staffIf you experience vaginal bleeding during your third trimester, contact your health care provider right away. If the bleeding is severe, seek emergency care.
Often, placenta accreta is suspected after an ultrasound early in pregnancy. A follow-up visit can give you an opportunity to find out about the condition and develop a plan to manage it.
What you can do
Before your appointment, you might want to:
- Ask about pre-appointment restrictions. In most cases, you'll be seen immediately. If your appointment will be delayed, ask whether you should restrict your activity in the meantime.
- Ask a loved one or friend to join you for the appointment. Fear and anxiety might make it difficult to focus on what your health care provider says. Take someone along who can help you remember all the information.
- Write down questions to ask your health care provider. That way, you won't forget anything important that you want to ask, and you can make the most of your time with your health care provider.
Below are some basic questions to ask your health care provider about placenta accreta:
- What's causing the bleeding?
- What treatment approach do you recommend?
- What follow-up care will I need during the rest of my pregnancy?
- What signs or symptoms should cause me to call you?
- What signs or symptoms should cause me to go to the hospital?
- Will I be able to deliver vaginally?
- Does this condition increase the risk of complications during future pregnancies?
- Will I need to have a hysterectomy after the baby is born?
In addition to the questions you've prepared, don't hesitate to ask other questions during your appointment — especially if you need clarification or you don't understand something.
What to expect from your doctor
Your health care provider is likely to ask you a number of questions, too. For example:
- When did you first notice vaginal bleeding?
- Did you bleed only once, or has the bleeding come and gone?
- How heavy is the bleeding?
- Is the bleeding accompanied by pain or contractions?
- Have you had any previous pregnancies that I'm not aware of?
- Have you had any uterine surgeries that I'm not aware of?
- How long would it take to get to the hospital in an emergency, including time to arrange child care and transportation?
References
- Resnik R. Diagnosis and management of placenta accreta. http://www.uptodate.com/index. Accessed March 21, 2012.
- Weeks A. Diagnosis and management of retained placenta after vaginal birth. http://www.uptodate.com/index. Accessed March 21, 2012.
- DeCherney AH, et al. Current Diagnosis & Treatment Obstetrics & Gynecology. 10th ed. New York, N.Y.: The McGraw-Hill Companies; 2007. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=9. Accessed March 21, 2012.
- American College of Obstetricians and Gynecologists. Your Pregnancy and Childbirth Month to Month. 5th ed. Washington, D.C.: American College of Obstetricians and Gynecologists; 2010:373.
- Silverman F, et al. Management of the third stage of labor. http://www.uptodate.com/index. Accessed March 21, 2012.
- Jauniaux E, et al. Placenta accreta: Pathogenesis of 20th century iatrogenic uterine disease. Placenta. 2012;33:244.
- Marc I, et al. Mind-body interventions during pregnancy for preventing or treating women's anxiety (review). Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007559.pub2/abstract. Accessed March 26, 2012.
- Gielchinksy Y, et al. Placenta accreta - Summary of 10 years: A survey of 310 cases. Placenta. 2002;23:210.
- Wright JD, et al. Predictors of massive blood loss in women with placenta accrete. American Journal of Obstetrics and Gynecology. 2011;205:38.e1.
- Eller AG. Optimal management strategies for placenta accreta. BJOG: An International Journal of Obstetrics and Gynaecology. 2009;116:648.
- Danforth's Obstetrics and Gynecology. 10th ed. Philadelphia, Pa.: Wolters Kluwer Health Lippincott Williams & Wilkins; 2008:1.
- Society for Maternal-Fetal Medicine. Placenta accreta. American College of Obstetricians and Gynecologists. 2010;203:430.
- Frequently asked questions. Special procedures FAQ 008. Hysterectomy. American College of Obstetrics and Gynecology. http://www.acog.org/~/media/For%20Patients/faq008.pdf?dmc=1&ts=20120326T1355412038. Accessed March 26, 2012.
- Gielchinksy Y, et al. Perinatal outcomes of pregnancies complicated by placenta accrete. Obstetrics & Gynecology. 2004;104:527.
- Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. March 28, 2012.
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