Scars from previous surgeries such as cesarean section, fibroid removal (myomectomy), Asherman’s syndrome, or dilation and curettage (D&C) can increase your risk for placenta accreta spectrum disorder. There are other non-surgical risk factors for PAS, including advanced maternal age and in vitro fertilization. You are at higher risk for placenta accreta if your placenta is set lower in your uterus. This is called placenta previa or low-lying placenta, and it makes it easier for the placenta to attach abnormally to the uterine muscle.
Placenta Accreta
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Placenta accreta spectrum (PAS) is a rare condition that can cause complications during your pregnancy and the delivery of your baby. If you have PAS, part or all of your placenta may remain attached to the uterus after childbirth, which could cause severe bleeding or postpartum hemorrhage. If you are at risk for this condition, you will receive care from Duke perinatologists (high-risk pregnancy doctors), who can perform a specialized screening ultrasound and surgical care when needed. We are here for you from the moment placenta accreta spectrum is suspected, during your pregnancy and delivery, as well as your postpartum recovery.
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Causes of Placenta Accreta
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Screening for Placenta Accreta
Screening for placenta accreta spectrum is recommended based on your surgical history, ultrasound results, and other risk factors. Your obstetrician may recommend screening for placenta accreta spectrum if an ultrasound shows that the placenta is near a previous uterine scar. Let your obstetrician know if you have ever had a surgery involving the uterus, such as a cesarean section or a D&C, have a history of Asherman’s syndrome, or if you have experienced postpartum hemorrhage during a previous pregnancy.
To screen for placenta accreta spectrum, your perinatologist will perform a specialized, detailed ultrasound. This ultrasound can detect PAS and its severity. The procedure often requires a full bladder and may include both transabdominal and transvaginal ultrasound.
Prenatal Care with Placenta Accreta
Your prenatal care will depend on the severity of your placenta accreta. If you have suspected high grade (or severe) placenta accreta, a perinatologist will work alongside your primary obstetrician to ensure a safe delivery for you and your baby. You may need to attend extra delivery planning and prenatal visits to ensure you are as healthy as possible throughout your pregnancy and set up for safety during your delivery.
Your doctor may coordinate additional care with experts from perinatology, neonatology, anesthesiology, blood transfusion specialists, and interventional radiology to ensure the safest outcomes for you and your baby.
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Recognized Among the Best Maternity Hospitals in the U.S.
Duke Regional Hospital is recognized among the best hospitals in the U.S. for maternity care by U.S. News & World Report for 2023-2024. The recognition notes our low rates of C-sections in people at low risk for pregnancy complications and other factors. Duke University Hospital's nationally-ranked obstetrics and gynecology program is the highest-ranked program in North Carolina, according to U.S. News & World Report for 2024-2025.
Why Choose Duke
Setting the Standard for Care
Duke is part of the Pan-American Society for Placenta Accreta Spectrum (PAS2), an international network of hospitals and experts in placenta accreta spectrum that shares research and innovations about the best ways to care for people with placenta accreta. Our placenta accreta spectrum doctors serve and have served on the board of directors for PAS2 and play a major role in creating and authoring guidelines that set the standard of care for placenta accreta spectrum.
Highly Experienced Team
Our specialized team at Duke cares for more placenta accreta cases than any other hospital in North Carolina and the southeast region.
We Prioritize Your Support System
We know your support system is important. We do our best to ensure you are awake to meet your baby and allow you to have someone in the room with you while you give birth. While you recover, you will be close to your baby. Our postpartum unit is in close proximity to Duke’s transitional nursery and NICU so you’re close to your baby no matter what level of care they need.
Specialized Care When Your Baby Needs It
As a Level IV Neonatal Intensive Care Unit we provide the highest level of neonatal medicine for babies born with complex care needs.
This page was medically reviewed on 05/29/2025 by