When Patricia Perich, 41, was 24 weeks pregnant with her fourth child, she was diagnosed with a potentially fatal condition called placenta accreta. This condition occurs when blood vessels from the placenta grow too deeply into the uterus and even infiltrate other organs.
"My advanced maternal age actually led to the diagnosis of this condition, because I had regular ultrasounds," Ms. Perich said. "But once I was diagnosed, I saw several doctors who couldn't help me."
With placenta accreta, part or all of the placenta remains strongly attached to the uterine wall. Patients typically need a C-section followed by the surgical removal of the uterus. This can cause severe blood loss and even death, if not managed correctly. As many as 90 percent of patients with placenta accreta require a blood transfusion and maternal death rates are as high as 7 percent.
To complicate matters, Ms. Perich also has a blood disorder, which required her to take blood thinners, increasing her risk for severe blood loss during delivery. Given the circumstances, Ms. Perich did her research and found Paula Melone, DO, at Loyola University Medical Center, a maternal-fetal medicine doctor who specializes in high-risk pregnancies and patients with complications involving the placenta.
"I sobbed after watching a video where she described her expertise in caring for women with placenta accreta, because I thought, 'This is the doctor who is going to save my life,'" Ms. Perich said. "I called her office, and she rearranged her schedule to see me at 7:30 the next morning. We bonded immediately. She was honest about the risks, but she eased my fears. I felt prepared to take on my condition after I met with her."
Ms. Perich saw Dr. Melone several times during her pregnancy. She also made arrangements for her to see top Loyola specialists in urogynecology, radiology and neonatology.
"Diagnosis of placenta accreta before delivery allows for multidisciplinary planning to minimize the risks for these women and their babies," said Dr. Melone, assistant professor of maternal-fetal medicine, Loyola University Chicago Stritch School of Medicine. "At Loyola, we work closely with the patient and a team of experts to offer the highest level of care throughout their pregnancy."
The American College of Obstetricians and Gynecologists reports that placenta accreta develops in approximately one in 533 pregnancies. This is an increase from the 1970s when one in 4,027 women was affected. This increase appears to be parallel to rising C-section rates. In fact, women at greatest risk for placenta accreta are those who have damage to the uterine wall caused by a previous C-section.
On November 21, one month before her due date, Ms. Perich entered Loyola's labor and delivery operating room for a scheduled pre-term C-section and hysterectomy. She was surrounded by a team of physicians and nurses led by Dr. Melone as well as a team from Loyola's level-III neonatal intensive care unit who were prepared to manage the care of her baby upon delivery.
Dr. Melone performed the C-section to bring Ms. Perich's baby girl Delaney into the world. She weighed 8 pounds, 6 ounces. Delaney was immediately evaluated by the NICU staff while Dr. Melone continued operating on Ms. Perich to complete her hysterectomy. Ms. Perich survived the surgery and was up and walking the next day.
"My baby girl and I were home four days later," Ms. Perich said. "The recovery was easier than what I experienced with my two previous C-sections. I give Dr. Melone all of the credit."
Cite This Page: