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Thursday, April 2, 2015

Give Blood for Those Who Give Life

Accreta Awareness Blood Drive - this month
April is Cesarean Awareness Month.

One of the results of a high cesarean rate is an increase in the risk for Placenta Accreta, where the placenta attaches too deeply into the uterus. This means the placenta has difficulty separating after the birth, greatly increasing the risk for life-threatening hemorrhage, hysterectomy, prematurity, and even death. 

Most people recognize the immediate risks of cesarean, which basically are the risks of any surgery: infection, bleeding, scar tissue, anesthesia problems. However, what many are not aware of are late complications from cesareans, those that occur in future pregnancies after a cesarean. In particular, the risk for abnormal placentation rises with each successive cesarean. These include:
  • placental abruption (the placenta shearing off before the baby is ready to be born) 
  • placenta previa (a low-lying placenta that covers or nearly covers the cervix)
  • placenta accreta (an abnormally attached placenta that has difficulty detaching after birth)
All of these can be life-threatening to both mother and baby, but placenta accreta is particularly serious. I've written about Placenta Accreta before in a 4-part series:
  • Part One - What Is Placenta Accreta?
  • Part Two - Life-Threatening Complication of Prior Cesarean 
  • Part Three - Risks to Mother and Baby
  • Part Four - Diagnosis, Treatment, and a Cautionary Story
Placenta Accreta is a real problem and one that is increasing all the time because the underlying cesarean rate is so high in some areas.

Keep in mind that the absolute numerical risk is low; most women who have had cesareans will not experience an accreta. However, the more cesareans you have had, the more at-risk for accreta you are. That's why it's so important that women not be forced into an automatic repeat c-section after a first cesarean, as women in many areas are due to VBAC bans in hospitals.

Some data indicates that the accreta rate has risen from about 1 in 4000 in the 1970s to about 1 in 533 these days. The main culprit in this is the increase in the number of cesareans, both primary but especially in repeat cesareans.

It's one thing when a cesarean truly saves a life; no one begrudges a truly necessary cesarean. It's a miracle that such technology and skill exists and it's a blessed intervention when applied appropriately. It's the cesarean done without medical indication that is the real problem, and VBAC bans in particular are putting more and more mothers and babies at risk.

Accreta Awareness Blood Drive

Brandy and her miracle baby
after a life-threatening accreta
I followed up my accreta series last year with Brandy's Story, where I told the story of an online friend who developed Placenta Accreta and hemorrhaged badly.

Normal blood loss in a vaginal birth is 500 ml; 1000 ml in a cesarean. Brandy lost 7,500 ml. That's seven THOUSAND five hundred; in other words, she had more than seven times the normal blood loss for a cesarean. Because the main artery of her placenta had burrowed deep into her cervix, she ended up losing her uterus. Thank goodness Brandy's baby survived, but Brandy lost her uterus, her future fertility, and nearly her life because previous doctors had pressured her into some cesareans she didn't truly need. 

Placenta Accreta is real and affects real women and babies. Do enough cesareans, and increasing numbers of women will face this devastating and life-threatening complication. 

As I've noted before, I've known several women now who have been affected by accreta; all suffered severe hemorrhages and several lost their fertility and uteri forever.

A different acquaintance of mine lost her baby and very nearly her life too. If she hadn't been transferred to a major regional hospital with a protocol and resources for extreme blood loss, she almost surely would have died (she came very close to death even with that protocol and multiple blood transfusions).

Although most women with accreta do survive, many suffer significant health consequences. And of course, occasionally women do die, usually of blood loss. Nationwide, we have seen a number of women who have lost their lives (or had near misses) from accreta.

Brandy almost lost her life too; she survived only because of massive blood transfusions. As a thank-you to the care providers who heroically helped save her life during her accreta surgery and as a thank-you to those who saved her life by giving blood previously, she started an Accreta Awareness Blood Drive.

So in April, in honor of Cesarean Awareness Month and all the mothers who have experienced accreta, please consider donating blood to the American Red Cross. Do it for the mothers who may experience severe bleeding during pregnancy due to accreta or other complications. Do it for the fathers, so they don't lose their wives. Do it for the families, so the children don't grow up without their mothers.

[Below is the publicity release from ICAN and places where you can donate to this specific campaign. Of course, if you don't have a Hope for Accreta Awareness campaign event near you or cannot donate this month, you can always call the Red Cross and just donate blood at one of their regular events.] 
The International Cesarean Awareness Network is pleased to be participating in this year's Accreta Awareness Blood Drive occurring nationwide on April 3rd in support of the Hope for Accreta Foundation.  
The purpose of this blood drive is to raise awareness of placenta accreta, a condition in which the placenta attaches itself too deeply into the uterus. Placenta accreta is also a risk of repeat cesarean whose treatment often requires emergency blood transfusion after birth.

In July of 2012, the American College of Obstetricians and Gynecologists issued a committee opinion on placenta accreta. It stated that "the incidence of placenta accreta has increased and seems to parallel the increasing cesarean delivery rate." Additionally, they also stated that "women at greatest risk of placenta accreta are those who have myometrial damage caused by a previous cesarean delivery with either anterior or posterior placenta previa overlying the uterine scar. The authors of one study found that in the presence of a placenta previa, the risk of placenta accreta was 3%, 11%, 40%, 61%, and 67% for the first, second, third, fourth, and fifth or greater repeat cesarean deliveries, respectively." (1)

In light of this, it is now more important than ever that women be made fully aware of placenta accreta. Find a blood drive near you! Click here for a list of blood drives available. 
Support Groups for Women with Accreta:
*post edited 4/3/15 to include some additional links

1 comment:

  1. Darn it, I gave blood on March 10, so I won't be eligible this month. I had placenta previa and spent nine weeks in the hospital before my son was born. I didn't ever need a transfusion, but they kept blood on the floor for me at all times during those weeks, just in case.

    Please, everyone, give if you are eligible.

    ReplyDelete