Why Is Placenta Accreta Now Considered a Spectrum Disorder?

Placenta accreta is the condition that results when the placenta abnormally grows into the wall of the uterus. This potentially serious problem can complicate your pregnancy and delivery. Just to confuse matters, researchers now define what was initially named placenta accreta as placenta accreta spectrum disorder or PAS disorder for short. A diagnosis of PAS can impact the care you receive during your pregnancy and the type of delivery you have. With a better understanding of PAS, provided below and with The Pulses’ helpful list of questions for your doctor, you can prepare to be an informed and empowered member The post Why Is Placenta Accreta Now Considered a Spectrum Disorder? appeared first on The Pulse.

Why Is Placenta Accreta Now Considered a Spectrum Disorder?

Placenta accreta is the condition that results when the placenta abnormally grows into the wall of the uterus. This potentially serious problem can complicate your pregnancy and delivery. Just to confuse matters, researchers now define what was initially named placenta accreta as placenta accreta spectrum disorder or PAS disorder for short. A diagnosis of PAS can impact the care you receive during your pregnancy and the type of delivery you have. With a better understanding of PAS, provided below and with The Pulses’ helpful list of questions for your doctor, you can prepare to be an informed and empowered member of your pregnancy care team.

What Do We Know About Placenta Accreta Spectrum?

Think of PAS as the umbrella term for all of the various kinds of abnormal placental growth during pregnancy. Doctors and researchers switched to using the spectrum concept to better classify abnormal placental growth for more accurate research findings. The three main types of PAS are placenta accreta, placenta increta, and placenta percreta.

The number of women with PAS is directly related to rising cesarean rates worldwide. The more C-sections a woman has, the greater her risk for PAS. More than 90% of all women experiencing PAS also have placenta previa. In placenta previa, the placenta attaches lower in the uterus such that it either partially or entirely blocks the cervix. The combination of PAS and placenta previa can prove very dangerous for women and their babies, putting moms at risk for life-threatening bleeding at the time of their delivery.

We also know that women who have had other kinds of uterine surgeries but who have not been pregnant are at risk for PAS, even in their first pregnancy. Prior abortions, endometrial ablations, myomectomies, and surgery to repair uterine abnormalities all increase risk. Current research also shows that in vitro fertilization (IVF), especially with cryopreserved embryos, increases the risk for PAS between 4- to 13-fold.

Early Diagnosis Saves Lives

Modern obstetrics recommends moms with PAS deliver by scheduled C-section ahead of their expected delivery date, usually somewhere between 34-36 weeks. Unfortunately, recent population-based studies show that PAS remains undetected before delivery in half to two-thirds of PAS cases.

That is why the announcement of a new blood test for PAS is so exciting. Developed by an international team of researchers, this test can be performed during the first trimester, allowing for earlier referral for specialty care.  The NanoVelcro Chip technology can detect a type of placental cell associated with PAS in moms’ bloodstream.

Planned Cesarean Delivery To Reduce Risk of Hemorrhage and Preserve Fertility

Delivering by planned cesarean section at a tertiary-level care center with a multidisciplinary care team is the recommended plan for keeping you and your baby safe during delivery. However, the timing of when the delivery happens is individualized and must balance what is best for you (how great is your risk of hemorrhage) against what is best for your baby (how many weeks along in your pregnancy are you).

Preparations during pregnancy, such as treating any anemia you might have and monitoring your hemoglobin and iron levels, are recommended. If you start bleeding during pregnancy, your doctor may advise you to limit your physical activity or even hospitalize you before your scheduled cesarean section. The distance you live from a major hospital with maternal-fetal specialists, neonatologists, anesthesiologists, urologists, interventional radiologists, and blood bank may also determine your birth plan.

Most often, the safest way to avoid a hemorrhage at the time of the C-section is to remove the woman’s entire uterus (called a hysterectomy) with the placenta still attached. For women who wish to have more children, special surgical techniques can sometimes preserve their uterus, with or without removing the placenta at the time of your C-section. Unfortunately, there have not been enough studies to show whether a particular management technique is safer or more successful than another. If you know very strongly that you want to have more children, it is important that you discuss the various surgical and management options with your doctor(s) so that you can make an informed decision about your care.

What Questions To Ask Your Doctor

We all know that moment of panic in a doctor’s office. We receive a diagnosis or a treatment plan, and our brain starts to melt as we try to process. We leave the doctor’s office and then think of a laundry list of questions we wished we asked.

PAS is a complicated and high-risk pregnancy condition. You will need time and space to make sense of what this means for you for your pregnancy. As you process the implications of having a high-risk pregnancy, here is a helpful list of questions for you to consult. You can be an informed advocate for yourself and your baby, one-hundred percent involved in the shared decision-making process of your obstetrical care going forward.

  1. Do I have any risk factors for PAS? How are you preparing for the possibility of PAS at my delivery?
  2. Do you know what type of placenta accreta I have?
  3. Do I also have placenta previa?
  4. Will I be referred for specialty pregnancy care or delivery in another hospital or birth setting?
  5. What should I do or who should I call if I start having vaginal bleeding?
  6. Will I be put on bed rest? How active can I be during my pregnancy? Can I have penetrative sexual intercourse?
  7. Will I have a scheduled C-section and what will determine the timing of that C-section?
  8. What can you do to try to preserve my fertility (if desired)? For example, is a Cesarean delivery with uterine preservation possible?

References:

  1. Jauniaux E, Hussein AM, Fox KA, Collins SL. New evidence-based diagnostic and management strategies for placenta accreta spectrum disorders. Best Pract Res Clin Obstet Gynaecol. 2019 Nov;61:75-88
  2. Afshar Y, Dong J, Zhao P, Li L, Wang S, Zhang RY, Zhang C, Yin O, Han CS, Einerson BD, Gonzalez TL, Zhang H, Zhou A, Yang Z, Chou SJ, Sun N, Cheng J, Zhu H, Wang J, Zhang TX, Lee YT, Wang JJ, Teng PC, Yang P, Qi D, Zhao M, Sim MS, Zhe R, Goldstein JD, Williams J 3rd, Wang X, Zhang Q, Platt LD, Zou C, Pisarska MD, Tseng HR, Zhu Y. Circulating trophoblast cell clusters for early detection of placenta accreta spectrum disorders. Nat Commun. 2021 Aug 3;12(1):4408.
  3. Xiyao Liu, Yu Wang, Yue Wu, Jing Zeng, Xi Yuan, Chao Tong, Hongbo Qi. What we know about placenta accreta spectrum (PAS), European Journal of Obstetrics & Gynecology and Reproductive Biology. 2021 April;259: 81-89.

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Cotton Pad Turtle Craft for Preschoolers

Create cute turtle craft using cotton pads and coloured water. This turtle craft is a fun activity that you can do anytime of the year. The post Cotton Pad Turtle Craft for Preschoolers appeared first on HAPPY TODDLER PLAYTIME.

Cotton Pad Turtle Craft for Preschoolers

INSIDE: Create an adorable turtle craft using cotton pads and coloured water. This turtle craft is a fun activity and craft that you can do any time of the year. Creating a turtle is a lot of fun for toddlers and preschooler and this fine motor activity is great for building the strength in little hands. Cotton Pad turtle craft is also great for talk and learning about colour mixing!

Age Suitability

This activity is good for kids 3 years and up. My kids are 3.5, 3.5, and 7 year old.

Exciting Sensory Bins for Curious Kids

Did you know I wrote a book of sensory bins? Click here for more information Exciting Sensory Bin for Curious Kids. Or grab your copy at Amazon.

Engage your child in hours of play with my colorful collection of sensory bin activities that aid with memory formation, language development, problem-solving skills and more. Perfect for toddlers from eighteen months to three years old and beyond, each bin makes use of materials you already have at home and helps reignite your kids’ interest in toys long forgotten.

Boring afternoons are made exciting with awesome animal-based bins, like Salty Shark Bay or Yarn Farm. Pretend play bins like Birthday Cake Sensory Play or Bubble Tea Party encourage creativity and imagination. And your kids will have so much fun they won’t even know they’re getting smarter with STEAM (science, technology, engineering, art and math) activities like Sink or Float Soup, Magnetic Letter Hunt or Ice Cream Scoop and Count.

Cotton Pad Turtle Craft for Preschoolers

I have included some questions and comments you can use to help get your toddler, preschooler or kindergartner talking during this craft. Don’t force it. If your child would rather create in silence that is completely fine too! They are still learning and gaining valuable skills!

Today we are going to make a make and colour in a turtle! What is the home of a turtle?

  1. Grab a piece of cardboard. You’ll want it to be large enough to fit the turtle and have extra room around it to help to keep the mess down.

What shape is a turtle shell? Square? Triangle? Circle?

  1. Invite child to draw a big circle in the middle for the shell using a green paint stick or marker.

We are going to colour in the shell in a special way, so let’s leave blank for now. What else does a turtle have? Head. Where is it?

  1. Invite child to draw a smaller circle at the top of the bigger circle. 

How many legs does a turtle have? Does it have a tail?

  1. Invite child to draw a two smaller oval/circles on each side of the larger circle. And a small tail

What colour is the turtle? many legs does a turtle have?

  1. Colour in the head and legs green. Leave the large circle blank.
  2. Hand preschooler a squeeze bottle of glue or glue stick and invite them to trace the body of the turtle with the glue. Also have them squeeze glue all inside the turtle. 
  3. Then have them stick cotton pads in the glue to create the shell of the turtle.
  4. Next, have then glue down a googley eye on the turtle head.

Decorating the Cotton Pad Turtle Shell

Is a turtle shell white? No! What colour is it? We are going to use coloured water to colour out turtle shell.

  1. Practice using the eye droppers so they get the hang of squeezing and letting go to draw the water up the eye dropper.
  2. Grab some bowls, add a few drops of brown yellow and blue food colouring into each bowl and mix with a small amount of water.
  3. Invite your child to use the eye droppers to colour the cotton pad turtle!
  4. Save the craft by getting your child to suck up any extra water in the cotton pads. Set aside to dry.

What colours do we have? How can we make green? How can we make brown?

Can you tell me about your turtle? How did you make this colour? Your use of blue in the middle is really eye catching!

How do you feel about your turtle? Are you a proud artist?

Supplies

(This post and list contains affiliate links for your convenience. If you make a purchase using one of these links, I may earn a commission. Please visit my disclosure policy for more information.)

  • Cardboard
  • Cotton pads
  • Glue
  • Pencil or Sharpie
  • Eye Droppers
  • Bowls
  • Water
  • Food Colouring
  • Googley eye

STEAM Activity Book

Looking for a fun activity book for your preschooler this summer? Check out my new book Super STEAM Activity Book: Launch Learning with Fun Mazes, Dot-to-Dots, Search-the-Page Puzzles, and More! ! Click here to learn more or order it now!

WILL YOU MAKE A COTTON PAD TURTLE CRAFT WITH YOUR CHILD? PIN IT FOR LATER!

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