Undiagnosed placenta previa percreta presenting as an obstetric emergency to the district hospital with inexperienced surgeons: Case report and review of the literature
Keywords:Cesarean Hysterectomy, Undiagnosed plasenta previa percreata, Inadequate Hospital Conditions
Placenta previa, a placental implantation anomaly where the placenta is located close to the internal os, has an incidence of 0.5%. One of the most important complications of placenta previa is the presence of placenta percreta. Nowadays, the incidence of placenta percreta has increased due to the increase in the number of cesarean sections. Maternal morbidity in such cases comprise massive transfusion, development of disseminated intravascular coagulation, uterine rupture, cystostomy, fistula formation, ureteral stricture, intensive care unit admission, infection, prolonged hospitalization, adult respiratory distress syndrome, renal failure, septicemia and even death. The aim of this research is to report how the inexperienced surgeons who were caught unprepared reacted in the case of undiagnosed placenta previa percreta. We aimed to make this case report a guide to saving the life of mother with placental previa percreta and baby under inadequate hospital conditions. Similar cases may be encountered by every young surgeon at any time.
Sumigama S, Itakura A, Ota T, Okada M, Kotani T, Hayakawa H, et al. Placenta previa increta/percreta in Japan: a retrospective study of ultrasound findings, management, and clinical course. J Obstet Gynaecol Res. 2007;33:606–11.
Tikkanen M, Paavonen J, Loukovaara M, Stefanovic V. Antenatal diagnosis of placenta accreta leads to reduced blood loss. Acta Obstet Gynecol Scand. 2011;90:1140–6.
Oyelese Y, Smulian JC. Placenta previa, placenta accreta, and vasa previa. Obstet Gynecol. 2006;107:927–41.
Belfort MA. Placenta accreta. Am J Obstet Gynecol. 2010;203:430–9.
Ibrahim MA, Liu A, Dalpiaz A, Schwamb R, Warren K, Khan SA. Urological Manifestations of Placenta Percreta. Curr Urol. 2015;8(2):57-65.
Hudon L, Belfort MA, Broome DR. Diagnosis and management of placenta percreta: a review. Obstet Gynecol Surv. 1998;53:509–17.
Wright JD, Pri-Paz S, Herzog TJ. Predictors of massive blood loss in women with placenta accreta. Am. J. Obstet. Gynecol. 2011;205(38):1-6.
Sentilhes. Maternal outcome after conservative treatment of placenta accreta. Obstet. Gynecol. 2010;115(3):526–34.
Iacovelli A, Liberati M, Khalil A, Timor-Trisch I, Leombroni M, Buca D, et al. Risk factors for abnormally invasive placenta: a systematic review and meta-analysis. J Matern Fetal Neonatal Med. 2018 Jul;22:1-11. DOI:10.1080/14767058.2018.1493453.
Berkley EM, Abuhamad AZ. Prenatal Diagnosis of Placenta Accreta Is Sonography All We Need? Ultrasound Med. 2013;32:1345–50.
D'Antonio F, Timor-Tritsch IE, Palacios-Jaraquemada J, Monteagudo A, Buca D, Forlani F, et al. First-trimester detection of abnormally invasive placenta in high-risk women: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2018Feb;51(2):176-83. DOI: 10.1002/uog.18840. Review.
Rac MW, Dashe JS, Wells CE, Moschos E, McIn-tire DD, Twickler DM. Ultrasound predictors of placental invasion: the Placenta Accreta Index. Am J Obstet Gynecol. 2015 Mar;212(3):343:e1-7.
Chou MM, Ho ESC, Lee YH. Prenatal diagnosis of placenta previa accreta by transabdominal color Doppler ultrasound. Ultrasound Obstet Gynecol. 2000;15:28–35.
Konstantinidou AE, Bourgioti C, Fotopoulos S, Souka E, Nikolaidou ME, Zafeiropoulou K, et al. Stripped fetal vessel sign: a novel pathological feature of abnormal fetal vasculature in placenta accreta spectrum disorders with MRI correlates. Placenta. 2019 Jul 9. pii: S0143-4004(19)30515-6. DOI: 10.1016/j.placenta.2019.07.005.
Stanleigh J, Michaeli J, Armon S, Khatib F, Zuckerman B, Shaya M, et al. Maternal and neonatal outcomes following a proactive peripartum multidisciplinary management protocol for placenta creta spectrum as compared to the urgent delivery. Eur J Obstet Gynecol Reprod Biol. 2019 Jun;237:139-44. doi: 10.1016/j.ejogrb.2019.04.032. Epub 2019 Apr 19.
Aggarwal R, Suneja A, Vaid NB, Yadav P, Sharma A, Mishra K.Morbidly adherent placenta: a critical review. J Obstet Gynaecol India. 2012 Feb;62(1):57-61. DOI: 10.1007/s13224-012-0149-5.Epub 2012 Apr 20.
Karlı P, Şahin B, Kara F. The incidence of isthmocele may be higher than reported. J Surg Med. 2018;2(3):283-7.
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