Urgent Call for Improved Diagnosis of Placenta Accreta Spectrum in the NHS

Placenta accreta spectrum (PAS) is a serious pregnancy complication where the placenta attaches too deeply into the uterine wall, potentially leading to severe hemorrhage during childbirth. The condition is particularly concerning for women who have previously undergone cesarean sections or in vitro fertilization (IVF). Current estimates suggest that PAS affects between 1 in 300 and 1 in 2,000 pregnancies, although some studies indicate a prevalence as high as 1 in 111 pregnancies, particularly in the context of rising cesarean rates in the UK.

The GuardianThe Guardian

Amisha Adhia, a mother who experienced life-threatening complications due to undiagnosed PAS, has launched the "Action for Accreta" campaign to raise awareness and push for better diagnostic practices within the National Health Service (NHS). Adhia's ordeal began when five hospitals failed to recognize her condition, leading to a near-fatal experience during childbirth. She lost nearly a liter of blood but ultimately received appropriate care thanks to Dr. Chineze Otigbah, who correctly diagnosed her condition.

The Independent

Adhia's campaign has garnered support from various maternal health organizations, including Birthrights and the Birth Trauma Association, highlighting the urgent need for improved awareness and training among NHS maternity staff. The campaign aims to address the "dangerous gaps" in care that could endanger the lives of mothers and their babies.

The Independent

The Royal College of Obstetricians and Gynaecologists (RCOG) acknowledges the increasing incidence of PAS and emphasizes the importance of early identification through pregnancy scans. An RCOG spokesperson stated, "Early identification of placenta accreta through pregnancy scans and appropriate follow-up imaging is extremely important." The RCOG is expected to release updated guidelines later this year to enhance the management of PAS.

The Guardian

However, critics argue that the current NHS guidelines are outdated and do not adequately address atypical presentations of PAS, as experienced by Adhia. Dr. Otigbah expressed concern that the NHS has not kept pace with the rising rates of cesarean births and IVF, which are significant risk factors for PAS.

The Guardian

Adhia's experience has sparked broader discussions about the NHS's handling of PAS. Critics, including health officials and maternal health advocates, have called for a national strategy to improve detection and treatment of PAS. Lord Philip Hunt, a former health minister, emphasized the need for mandatory reporting of PAS cases to better understand its prevalence and impact.

The Independent

The "Action for Accreta" campaign is pushing for urgent reforms, including updated training for maternity staff, improved tracking of PAS cases, and the establishment of specialized care units. The campaign's efforts coincide with a National Maternity Investigation led by Baroness Amos, which aims to drive improvements in maternity care and safety.

The Independent

• “I am alive today because Dr Otigbah recognised the danger and acted.” — Amisha Adhia, Campaigner

The Guardian

• “The main risk factors for PAS are C-sections and IVF, which have risen massively.” — Dr. Chineze Otigbah, Consultant Obstetrician

The Guardian

• “Leading pregnancy and baby loss charities Tommy’s and Sands, who are among the eight maternal health charities and patient safety groups so far backing the campaign, said: “Improving the identification, understanding and prevention of serious pregnancy complications depends on better data, stronger research, and listening to families’ experiences.” — Joint Statement from Tommy’s and Sands Charities

The Independent

The ongoing campaign and forthcoming guidelines may significantly impact how PAS is managed in the UK, potentially saving lives and improving outcomes for mothers and their infants.

The Independent