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Case Reports
. 2023 Sep 8:39:e00540.
doi: 10.1016/j.crwh.2023.e00540. eCollection 2023 Sep.

A one-step conservative surgical approach to undiagnosed focal accreta: A case report

Kumaressan Ragunathan  1 , Amin Bahabri  1 , Heidi Hughes-D'Aeth  1 , Arisudhan Anantharachagan  1
Affiliations
Case Reports

A one-step conservative surgical approach to undiagnosed focal accreta: A case report

Kumaressan Ragunathan et al. Case Rep Womens Health. .

Abstract

Placenta accreta spectrum (PAS) refers to abnormal trophoblast invasion into the myometrium. The global prevalence of PAS is rising as the number of caesarean deliveries increases. PAS is associated with higher rates of maternal morbidity and mortality. Although mainstream management has been caesarean hysterectomy, uterine conservative techniques are also used, such as the extirpative technique, leaving the placenta in situ, the triple-P procedure, embolisation, uterine balloon tamponade and methotrexate medication. This case report describes an innovative yet simple and safe technique, namely partial myometrial resection of the focal adherent placenta. Unlike hysterectomy, this technique can preserve fertility. It was performed on an undiagnosed focal placental accreta during a caesarean section with a routine caesarean section theatre set-up and did not require obstetric follow-up after the patient was discharged. This procedure can be considered an option for managing focal placenta accreta.

Keywords: Focal placental accreta; Partial myometrial resection.

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Figures

Fig. 1
Fig. 1
Focal placental accreta.
Fig. 2
Fig. 2
Chorionic villous implants directly onto myometrial fibres with no intervening decidua.
Fig. 3
Fig. 3
Pelvic ultrasound image 14 days after the caesarean section.
Fig. 4
Fig. 4
HyCoSy demonstrating normal uterine cavity and myometrial thickness.
See this image and copyright information in PMC

References

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