Placenta accreta in a referred post hysterotomy case: a bold step into the unknown
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20210338Keywords:
Placenta accreta, PPH, Uterine tamponade, Massive transfusion protocolAbstract
Placenta accreta spectrum encompasses a range of pathological adherence of placenta and causes significant maternal and neonatal morbidity and mortality. With the increase in the number of cesarean deliveries over the last few decades, there has been an 8 fold increase in the incidence of placenta accreta. The single most important risk factor reported in about half the cases of PAS disorders is placenta previa. Management involves a standardized approach with a comprehensive multidisciplinary care team accustomed to management of placenta accreta. We discuss a rare case of a patient who underwent hysterotomy in an outside hospital and was referred to our tertiary care centre as atonic PPH. Undiagnosed antenatally and at the time of hysterotomy, she was diagnosed as a case of placenta accreta on exploration at our institute and was surgically managed.
References
Allen L, Jauniaux E, Hobson S, Papillon-Smith J, Belfort MA, et al. FIGO consensus guidelines on placenta accreta spectrum disorders: Nonconservative surgical management. Int J Gynaecol Obstet. 2018;140(3):281-90.
American College of Obstetricians and Gynecologists; Society for Maternal-Fetal Medicine. Obstetric Care Consensus No. 7: Placenta Accreta Spectrum. Obstet Gynecol. 2018;132(6):e259-75.
Creanga AA, Bateman BT, Butwick AJ, Raleigh L, Maeda A, Kuklina E, et al. Morbidity associated with cesarean delivery in the United States: is placenta accreta an increasingly important contributor?. Am J Obstet Gynecol. 2015;213(3):384.e1-11.
Okunowo AA, Ohazurike EO, Habeebu-Adeyemi FM. Undiagnosed placenta praevia percreta: A rare case report and review of management. Niger Postgrad Med J. 2019;26:61-4
Pala Ş, Atilgan R, Başpınar M, Kavak EÇ, Yavuzkır Ş, Akyol A, et al. Comparison of results of Bakri balloon tamponade and caesarean hysterectomy in management of placenta accreta and increta: a retrospective study. J Obstet Gynaecol. 2018;38(2):194-9.
Gatta LA, Lockhart EL, James AH. Blood products in the management of abnormal placentation. Clin obstet gynecol. 2018;61(4):828-40.
Sharma V, Kaur J. Case report on placenta accreta presenting obstetric emergency. Int J Reprod Contracept Obstet Gynecol. 2016;5(9):3261-4.
Gadappa S, Deshpande S, Rajpurohit K, Kalyankar B. Placenta percreta-an audacious experience. Int J Reprod Contracept Obstet Gynecol. 2017;6(5):2112-4.