If you’ve been diagnosed with Placenta Accreta Spectrum (PAS), a Fetal Medicine appointment is essential for specialised care to safeguard your health and your baby’s well-being. PAS, a condition where the placenta attaches too deeply to the uterine wall, carries risks like severe bleeding, preterm birth, or complications during delivery. Fetal medicine specialists work closely with your healthcare team to monitor and manage these risks proactively.
What we do
What to Expect During Your Appointment
- Imaging and Placental Assessment
Ultrasound/MRI Scans: Detailed imaging checks the depth of placental invasion (e.g., accreta, increta, or percreta) and whether the placenta covers the cervix (praevia).
Tracking Changes: Regular scans monitor placental position, blood flow, and signs of complications like abnormal blood vessel growth.
- Fetal Growth and Well-Being
Growth Scans: Ensures your baby is developing properly, as PAS can sometimes restrict nutrient/oxygen supply.
Doppler Ultrasounds: Assesses blood flow in the umbilical cord and placenta to detect signs of fetal stress.
- Maternal Health Monitoring
Bleeding or Amaemia: Checks for vaginal bleeding, anaemia, or signs of preterm labour.
Blood Volume and Readiness: Evaluates your blood count and prepares for potential transfusions during delivery.
- Delivery Planning
Timing and Method: Most PAS deliveries are scheduled via caesarean hysterectomy (removing the uterus after delivery) between 34–36 weeks to balance fetal maturity and bleeding risks.
Multidisciplinary Coordination: Your team may include obstetricians, gynaecologists, anaesthetists, neonatologists and radiologists to ensure a safe delivery plan.
How Often Will You Have Appointments?
Visits every 2–4 weeks for imaging and check-ups.
Fetal medicine appointments focus on minimising risks through early detection, careful planning, and coordinated care. While PAS is complex, specialised monitoring ensures you and your team are prepared for a controlled, well-supported delivery.
Why You Might Need an MRI for Placenta Accreta Spectrum (PAS)
If you’ve been diagnosed with Placenta Accreta Spectrum (PAS), your care team may recommend an MRI (Magnetic Resonance Imaging) to gather detailed information about the placenta’s position, depth of invasion, and potential risks. While ultrasound is the primary tool for diagnosing PAS, MRI provides additional clarity in complex cases.
Clarifying Uncertain Ultrasound Findings
Ultrasound is excellent for initial PAS screening, but in some cases, it can’t fully assess the placenta’s depth or extent (e.g., if the placenta is posterior or obscured by scar tissue from prior surgeries).
When Is an MRI Typically Recommended?
- Unclear ultrasound results: If ultrasound can’t confirm the severity of PAS.
- Suspected placenta percreta: To check for bladder/bowel involvement.
- Posterior placenta: Harder to visualize via ultrasound in some cases.
- Prior uterine surgeries: Scarring (e.g., from multiple C-sections) may obscure ultrasound views.
Is MRI Safe in Pregnancy?
- Yes, when performed properly. MRI uses no radiation (unlike CT scans) and is considered safe in pregnancy.
- Contrast dye (gadolinium) is generally avoided unless absolutely necessary, as it crosses the placenta.
What to Expect During the MRI Scan
- The procedure is non-invasive and painless, but you’ll need to lie still for 30–60 minutes.
- Open or wide-bore MRI machines are often used for comfort, especially in later pregnancy.
How Results Affect Your Care
- If MRI confirms severe PAS, your team may:
- Schedule delivery earlier (e.g., 34–36 weeks).
- Involve specialists like urologists or vascular surgeons.
- Plan for blood transfusions or intensive care post-delivery.
