Rare pregnancy complication threatened two lives
At 3 weeks old and weighing just under 4 pounds, Penelope Elliott was starting to make funny faces. When another baby cried in the neonatal intensive care unit (NICU), Penelope would make a grumpy face.
Around that same time, Penelope’s mom, Theresa, was released from Norton Suburban Hospital. While she recuperated, dealing with pain and healing from surgery, her daughter remained in the hospital’s NICU to gain size and strength after being born 8 weeks early.
By all accounts, mother and daughter are lucky to be alive. But they are — and mom is getting her sense of humor back while Penelope is doing “just great,” according to Penelope’s dad, Daniel Elliott.
What happened to this mother and daughter — a condition called placenta percreta, or invasive placenta — occurs in approximately 1 in 2,500 births, said Jonathan Reinstine, M.D., obstetrician/gynecologist with Associates in Obstetrics & Gynecology, a Part of Norton Women’s Care.
Certain signs indicated that this rare but severe, and often fatal, complication could happen with Theresa. When her older daughter Livvy was born, Theresa underwent a caesarian section and experienced a complication that can cause severe bleeding before or during delivery. That put her at risk for placenta percreta, which led physicians to explore what difficulties they might face during Theresa’s second delivery.
Based on ultrasound results and MRI confirmation that she had placenta percreta, doctors put Theresa on hospital bed rest until delivery, so they could have their plan in place to help her and her baby.
“We made sure all specialists were on call and that there was blood in the bank every day just in case, so if something did happen we had a head start,” Dr. Reinstine said.
Theresa awoke on the last Sunday in July with intense pain, dizziness and nausea. She was bleeding internally and rushed into the operating room for an emergency cesarean section. Ultimately, more than 30 men and women worked together to save baby Penelope and her mom, who received 59 units of blood and countless other blood products.
After speaking with the family that day, Laura Gipe, director of patient care services at Norton Suburban Hospital, watched the surgery through a window into the operating room.
“I was amazed,” Gipe said. “There were so many people in the room, all very intensely focused on the patient.” Theresa, described by friends as a wonderful wife and mom to two sweet girls, spent about a week in the critical care unit, while Penelope spent about seven weeks in the NICU. The family is grateful for the knowledge and technology that made it possible for Theresa and Penelope to survive.
Gipe recalled once reading an article on placenta percreta.
“The article gave step-by-step details of how a perfect case would be managed. We did not miss a beat. There is no doubt in my mind that by the grace of God this patient was in the very best place in the world to receive the best care possible.”
Problems with the placenta
The placenta grows in the uterus (womb) and supplies the unborn baby with food and oxygen through the umbilical cord. Typically, the placenta grows onto the uterus and remains there until the baby is born. During the last stage of labor, the placenta separates from the wall of the uterus, and the mother’s contractions help push it into the birth canal and out of the body after the baby is born (the afterbirth).
Sometimes the placenta attaches to the wall of the uterus too deeply, which can cause one of the following conditions:
- Placenta accreta – The placenta attaches too deeply and firmly into the uterus.
- Placenta increta – The placenta attaches even more deeply into the muscle wall of uterus.
- Placenta percreta – The placenta attaches and grows through the uterus, sometimes extending to nearby organs, such as the bladder.
In these conditions, the placenta doesn’t completely separate from the uterus after birth. This can cause dangerous bleeding.
Signs of these conditions
Placental conditions often cause vaginal bleeding during the last few months of pregnancy. Call your physician right away if you have vaginal bleeding anytime during your pregnancy. If the bleeding is severe, go to the hospital right way.
Diagnosing placental conditions
These conditions usually are diagnosed using ultrasound. In some cases, the health care provider may use magnetic resonance imaging (MRI). MRI uses magnets and computers to make a clearer picture than what may be seen on an ultrasound. Both tests are painless and safe for mom and baby.