We met with Dr. Byrne today. She is a perinatologist at University of Utah Hospital. She has agreed to deliver me. I was surprised at how much I liked her. She exudes confidence and authority but at the same time treats me like I am not an idiot. It is always frustrating when the Dr.’s talk to me like I am in Kindergarten. That’s why I fired the last perinatologist Dr. Gainer at UVRMC. Dr. Byrne specializes in fetal anomalies.
While talking to her and reviewing my medical history, previous pregnancies, and records and ultrasounds from this pregnancy she discovered that the placenta is anterior and covers my previous C-section scar tissue (which I had realized when I had my 23 week ultrasound). I was impressed that in such little time she made this discovery and instead of messing around trying to figure out what she thought my due date was she actually performed her duties and uncovered something that could result in significant complications. My last perinatologist could not even figure out my due date (even though several ultrasounds coincide with my very accurate calculation).
Dr. Byrne ordered an immediate ultrasound to determine if the placenta was going to present a problem. She also informed us that there is a possibility that I have a placenta accreta. Placenta accreta is a severe obstetric complication involving an abnormally deep attachment of the placenta, through the endometrium and into the myometrium (the middle layer of the uterine wall). There are three forms of placenta accreta, distinguishable by the depth of penetration.
The placenta usually detaches from the uterine wall relatively easily, but women who encounter placenta accreta during childbirth are at great risk of hemorrhage during its removal. This commonly requires surgery to stem the bleeding and fully remove the placenta, and in severe forms can often lead to a hysterectomy or be fatal. Placenta accreta affects approximately 1 in 2,500 pregnancies.
Mine is not an obvious accrete, but it is common for the placenta to attach to the previous C-section scar tissue. The scar tissue is not vascular and obviously the placenta is highly vascular causing the placenta to grow deeper into the uterine wall in search of the blood supply that it needs.
Dr. Byrne believes that she will be able to go below the old scar line and we won’t have to do a midline incision, but we will have to wait to see about the placenta accrete until delivery.
Dr. Byrne is arranging the date and time for the C-section and will get back with us.
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