The multidisciplinary team that is part of Women’s Services at Children’s Memorial Hermann Hospital provides comprehensive, specialized care for women facing high-risk pregnancies, including those diagnosed with Placenta Accreta Spectrum (PAS) disorders. PAS is a serious condition where the placenta attaches too deeply into the wall of the uterus. It includes three forms: placenta accreta, placenta increta and placenta percreta.
As part of our commitment to maternal-fetal health, Women’s Services has established a specialized Accreta Program, in partnership with McGovern Medical School at UTHealth Houston, that brings together highly trained affiliated maternal-fetal medicine (MFM) specialists, obstetric anesthesiologists, neonatologists and surgical teams to deliver seamless, lifesaving care for both mother and baby. Patients are evaluated early, monitored closely and supported through their entire pregnancy journey.
Placenta accreta spectrum is being diagnosed more frequently, with incidence rising from 1 in 1,250 pregnancies in the 1980s to about 1 in 272 today. The risk increases significantly with each prior cesarean delivery, and nearly 35% of cases may go undiagnosed until delivery, which increases the potential for serious complications.
Memorial Hermann patients have access to leading-edge resources, including The Fetal Center at Children’s Memorial Hermann Hospital in the Texas Medical Center, affiliated with UTHealth Houston, and the hospital’s Level IV Neonatal Intensive Care Unit (NICU). We provide integrated care that includes inpatient monitoring, prenatal testing, advanced imaging, genetic counseling, surgical planning and neonatal preparedness all in one place.
Placenta accreta spectrum refers to a group of disorders classified into three distinct types based on how deeply the placenta invades the uterine wall.
Understanding the type of PAS is critical for planning safe delivery. More invasive forms like increta and percreta carry higher risks of heavy bleeding, organ involvement and the need for specialized surgical intervention.
Most cases of PAS are silent, meaning no symptoms are present until discovered through imaging. That’s why early screening and MFM referral are essential for women with known risk factors. However, certain signs and findings may suggest a possible PAS diagnosis and prompt additional evaluation, including:
In many cases, PAS is completely asymptomatic, which is why risk factor screening and early imaging are essential. At Children’s Memorial Hermann Hospital, our affiliated MFM team uses advanced diagnostic tools to detect PAS earlier and help patients receive the specialized care and planning they need for a safe pregnancy and delivery.
Certain factors can increase a woman’s risk of developing PAS disorders. Identifying these risk factors earlier in pregnancy helps provide the safest care plan for both mother and baby. These include:
When one or more of these risk factors are present, early referral to a MFM specialist is recommended. Through advanced imaging and collaborative planning, our team can diagnose PAS early and work to deliver the highest level of care throughout pregnancy and delivery.
Early and accurate diagnosis of PAS is critical to allow for the safest outcomes for both mother and baby. Our MFM specialists use advanced imaging technology to assess the placenta’s location, depth of invasion and relationship to surrounding organs.
The diagnostic process typically begins with a detailed obstetric ultrasound. This non-invasive test can often detect signs of abnormal placental attachment as early as the second trimester. Key ultrasound indicators of PAS may include:
In complex or inconclusive cases, an MRI scan may be performed. MRI provides a clearer view of the placenta’s depth of invasion and helps identify cases of placenta increta or percreta, especially when there is concern about involvement with nearby organs like the bladder or bowel.
In addition to imaging, your care team may assess maternal serum markers, medical history and symptoms to guide diagnosis. Our specialists also collaborate with your primary OB/GYN to determine the best time and place for delivery.
Each care plan is built around the specific needs of the patient and her pregnancy. Once a diagnosis of PAS is confirmed or strongly suspected, the patient is referred to a specialist who works in coordination with her primary OB/GYN.
The care team reviews the patient’s medical history, imaging results and type of PAS, whether accreta, increta or percreta. A detailed delivery plan is developed and adjusted as needed throughout the pregnancy. This often includes regular imaging appointments, consultations with specialists and delivery planning.
Delivery is typically scheduled as a planned cesarean hysterectomy, performed by a multidisciplinary team that includes MFM specialists, anesthesiologists, surgeons and neonatologists. A Level IV NICU is located within the same hospital, allowing for immediate care for the newborn if needed. Patients also have access to a nurse navigator who helps coordinate appointments, communicates with referring providers and supports the patient throughout her care. Social workers, counselors and other support staff are also available to help with logistics and provide resources for families. The goal is to provide clear communication, organized care and the right team in place to support a safe delivery for both mother and baby.
The Journey Support Program is available to patients facing high-risk pregnancies, including those with a PAS diagnosis, who are admitted to the Antepartum Care Unit. The program is designed to support patients during extended hospital stays by providing education, stress management tools and connection to resources.
An interdisciplinary team leads the program, offering services that include pregnancy education, wellness activities and one-on-one support. Patients have access to professionals such as a nurse navigator, Child Life specialist, therapist and chaplain. These team members help patients manage anxiety, celebrate milestones and stay informed about their care. The Journey Support Program was created to help patients feel more prepared and supported during a difficult time.
Expectant mothers at the Accreta Program are cared for by a specialized team experienced in managing PAS disorders. This includes affiliated MFM specialists, obstetric anesthesiologists, surgeons and neonatologists who work together to plan and deliver care based on each patient’s condition.
The team collaborates with referring OB/GYNs and may involve additional surgical or urology consultants when needed. A nurse navigator helps coordinate appointments and helps facilitate clear and consistent communication between providers. The neonatal team is present during delivery to care for the baby, especially in high-risk or preterm cases.
Memorial Hermann cares for more pregnant women in Houston1 than any other health system. From fetal and high-risk pregnancy care to midwife services and obstetric emergency care, we are here to support you. Plus tours and classes are available.
Learn more about our women’s health services across Houston »
“My doctor and I decided together to monitor it and follow up with another scan in a few weeks,” Maggie said. “I was so nervous after I first learned about my diagnosis, so I started doing all of this research on my own, and that’s when I first came across The Fetal ...
The Women’s Center at Children’s Memorial Hermann Hospital
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Hermann Pavilion 5th floor
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1 Stratasan data June 2023, 12-county Houston region