A new campaign is underway in the United Kingdom, spearheaded by Amisha Adhia, to address what she describes as dangerous gaps in NHS maternity care regarding the diagnosis of placenta accreta spectrum (PAS). Adhia’s initiative, “Action for Accreta,” follows a harrowing experience where five hospitals failed to identify her condition during pregnancy, a potentially life-threatening complication where the placenta grows too deeply into the uterine wall.
The campaign aims to push the National Health Service to improve early diagnosis of PAS, a rare but increasingly prevalent condition linked to rising rates of caesarean sections and IVF treatments. Without timely diagnosis, women are at risk of catastrophic bleeding, emergency hysterectomies, and even death during childbirth.
“Placenta accreta can cause catastrophic bleeding in minutes if it isn’t anticipated,” Adhia told The Guardian. She credits obstetrician Dr. Chineze Otigbah with ultimately recognizing the danger and enabling a planned caesarean section that limited blood loss to nearly a liter during the delivery of her daughter, Ishaani. “I’m alive today because Dr. Otigbah recognised the danger, and acted. I was reassured into danger. I was carrying a condition that could have killed us both. I felt ignored. I thought I was going to die.”
The Royal College of Obstetricians and Gynaecologists (RCOG) describes PAS as affecting between one in 300 and one in 2,000 pregnancies, noting that incidence rates are increasing both in the UK and globally. The RCOG emphasizes the “extremely important” role of early identification through ultrasound and follow-up imaging to allow for careful planning of care and specialized teams, ultimately improving outcomes for mothers and babies.
Dr. Otigbah expressed concern that women are “falling through the cracks” of the current system. She highlighted that the increasing prevalence of risk factors like C-sections and IVF haven’t been adequately addressed by the NHS. “All hospitals don’t have PAS specialists, so subtle warning signs can be missed,” she stated.
Currently, NHS England does not maintain a dedicated registry for PAS, making it hard to accurately measure the condition’s frequency. This lack of data contributes to the challenge of assessing the scale of the problem and allocating resources effectively.
Adhia and her husband, Nik, have testified before the inquiry led by Valerie Amos into maternity care in England, supported by organizations including Birthrights and the Birth Trauma Association. They are advocating for future RCOG recommendations to better incorporate atypical presentations of PAS and to ensure that high-risk pregnancies are referred to specialized centers.
Professor Donald Peebles of NHS England acknowledged the potential severity of PAS, stating that maternity teams are trained to identify warning signs, particularly in women with a history of caesarean sections, and to refer patients to specialized NHS centers when necessary. “The placenta accreta spectrum is rare, but when it occurs, it can cause potentially life-threatening bleeding, making early identification of high-risk pregnant women so important,” he said.
