On 2 April Marie Claire magazine published an interview with reality star Kim Kardashian wherein she revealed that, because she experienced placenta accreta when she was pregnant with her first baby North West, if she and rapper husband Kanye West conceive another child, it would likely be their last.
Placenta accreta causes internal tearing and the damaged muscle left behind can make it more difficult for future placentas to attach.
Kim says in a clip from the series: ‘I'm trying to get a hold of Kanye, because I just came from my fertility doctor and they need me to go into surgery to clear out something in my uterus,’
It is just the latest in their pregnancy woes - Kim has made her and Kanye’s difficulties to conceive known through the reality series Keeping Up With The Kardashians.
Although she lives a healthy life – she doesn't drink or smoke, she eats well and exercises regularly, Kim’s punishing public lifestyle, which creates stress and could rob her of sleep, could be contributing to her difficulty to conceive.
When couples struggle to conceive, Cape Town fertility expert Dr Sascha Edelstein says infertility causes in women include problems with ovulation, fallopian tubes, polycystic ovarian syndrome, pelvic inflammatory disease and sexually transmitted diseases.
Or, as a study in Reproductive Biomedicine shows, in up to 80% of couples it could simply be unexplained or idiopathic infertility where there just is no obvious cause and all the money in the world spent on intrauterine insemination (IUI), or artificial insemination are fruitless.
Read more on the Kardashians' health issues:
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What is Placenta Accreta?
In the conversation with West that was broadcast during the series (see below), Kim reveals the fertility expert told her:
“when you have your baby, this will be the last one, because the problem is your placenta grew on your uterus, so when you have another baby, your placenta will go right to that hole and then we'll have a team of doctors waiting right there, to remove your uterus and put you into emergency surgery right there because you can't bleed too much."
The doctor was referring to placenta accreta which is a potentially life-threatening obstetric condition.
In a normal pregnancy the placenta attaches to the uterine wall, but with placenta accreta, which affects and estimated 1 in 2 500 pregnancies, blood vessels and other parts of the placenta attach too deeply into the wall.
After childbirth, the placenta usually detaches from the uterine wall, but with placenta accreta part or all of the placenta remains firmly attached and this can cause severe blood loss after the child is born.
When placenta accreta is diagnosed in a pregnant mother – either through ultrasonography or magnetic resonance imaging – the baby will most likely be delivered via C-section and this will be followed by the surgical removal of the uterus (hysterectomy).
According to The American College of Obstetricians and Gynecologists, the incidence of placenta accreta has increased over the last decade and it seems to parallel the increase in caesarean deliveries.
This is not a risk factor for Kim who, according to reports, gave birth to baby girl North in June 2013 via natural delivery.
Placenta previa, where the placenta is implanted completely or partially over the cervix, is also regarded as a risk factor.
Watch: Kim tells Kanye about her visit to the fertility expert and that she wants nothing more than to have another baby in this excerpt from Keeping Up With The Kardashians
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Image: Kim Kardashian, from Shutterstock