Placenta Accreta: Woman’s Campaign Highlights NHS Diagnosis Failures | UK News

A growing number of women are facing life-threatening complications during childbirth due to a condition called placenta accreta spectrum (PAS), prompting a new campaign urging the National Health Service (NHS) to improve diagnosis and care. The campaign, launched by Amisha Adhia after her own harrowing experience, highlights the critical need for increased awareness and specialist expertise within maternity services.

Placenta accreta occurs when the placenta, the organ that provides nutrients and oxygen to the developing fetus, grows too deeply into the wall of the uterus. This abnormal implantation can lead to severe bleeding during or after delivery, potentially requiring emergency hysterectomy or, in the most tragic cases, resulting in maternal death. The condition can also block some or all of the cervix, complicating delivery.

Adhia’s case is particularly concerning. She was repeatedly assessed by specialists at five different London hospitals who initially dismissed the possibility of PAS. It wasn’t until she was under the care of consultant obstetrician Dr. Chineze Otigbah at Queen’s Hospital in Romford that the diagnosis was finally confirmed. “I am alive today because Dr Otigbah recognised the danger and acted,” Adhia stated. “I was repeatedly told that I had almost zero risk… But it was there and it was deeply invasive. I was reassured into danger.”

The NHS estimates that between one in 300 and one in 2,000 women develop placenta accreta. However, doctors are warning that the incidence is rising, largely due to the increasing number of births via Cesarean section. Currently, 45% of babies in England are delivered by C-section, slightly exceeding the 44% delivered vaginally. Women who have previously undergone a C-section or IVF treatment are at significantly higher risk of developing PAS.

The risks associated with PAS are substantial. Without timely diagnosis and appropriate management, women can experience catastrophic bleeding within minutes of placental separation. Dr. Otigbah emphasized the urgency, stating, “Placenta accreta can cause catastrophic bleeding in minutes if it isn’t anticipated.”

Adhia’s daughter, Ishaani, was delivered by planned C-section last September. While Adhia lost nearly a litre of blood during the procedure, she avoided the most severe complications, a testament to Dr. Otigbah’s intervention. The experience motivated Adhia and her husband, Nik, to establish the Action for Accreta campaign, aiming to raise awareness and advocate for improved screening and diagnostic protocols.

The campaign has already resonated with other women who have experienced similar challenges. Adhia reports that approximately 40 women who experienced setbacks during pregnancy or labor due to undiagnosed placenta accreta have contacted the couple after seeing their posts on social media.

A significant concern is the lack of comprehensive data collection regarding PAS within the NHS. Currently, there are no official figures tracking the prevalence of the condition or the associated complications. This lack of data hinders efforts to accurately assess the scope of the problem and implement targeted interventions. Even the annual MBBRACE-UK report on maternal health does not include specific details on placenta accreta.

Eight baby and maternal health groups, including Birthrights and the Birth Trauma Association, have voiced their support for the Action for Accreta campaign. Tommy’s and Sands, two leading baby charities, jointly released a statement welcoming the campaign’s focus on “highlighting important gaps in awareness, surveillance and learning” related to serious pregnancy complications.

Current guidance from the Royal College of Obstetricians and Gynaecologists (RCOG) acknowledges that placenta accreta and placenta praevia – another condition that can cause significant blood loss – are associated with high rates of maternal and neonatal morbidity and mortality. The RCOG notes that the incidence of both conditions is increasing due to the rise in C-sections, higher average maternal age, and increased use of assisted reproductive technologies.

The Adhias recently presented their experiences to Valerie Amos’s inquiry into maternity care in England, initiated by Health Secretary Wes Streeting. They urged the inquiry to recommend improvements in the NHS’s approach to identifying placenta accreta.

Dr. Otigbah echoed the call for improved systems, stating, “The NHS has not kept up to date with this reality. Not every hospital has PAS specialists, so subtle warning signs can be overlooked.” She also highlighted the need for updated guidance from the RCOG to include advice on diagnosing and managing atypical forms of PAS, such as the type Adhia experienced.

The RCOG has acknowledged the issue and stated that updated guidelines are expected to be published later this year. NHS England, through its national clinical director for maternity, Prof Donald Peebles, affirmed that maternity teams are trained to recognize the warning signs of PAS, particularly in women with a history of C-section. He also noted that patients at higher risk are referred to specialist NHS centers.

This campaign underscores the importance of vigilance, specialist expertise, and robust data collection in safeguarding maternal health and preventing potentially devastating outcomes associated with placenta accreta spectrum.