Cesarean delivery without uterine artery embolization for the management of placenta accreta spectrum disorder: case report and review of the literature

Abstract

Placenta accreta is the abnormal adherence of the placenta to the myometrium. Its incidence is about 0.33% of all deliveries. And it´s associated with considerable maternal morbidity including large volume of blood transfusion, peripartum hysterectomy, cystotomy, intensive care unit (ICU) admission, infection, and prolonged hospitalisation. Identifying risk factors as placenta previa, maternal age over 35 years, grandmultiparity, previous curettage, previous myomectomy, previous uterine surgery, submucous myoma, Asherman´s syndrome and a short caesarean-to-conception interval, is important to perform ultrasound and magnetic resonance imaging. Planned caesarean hysterectomy performed at an earlier gestation to avoid emergency delivery in women with suspected placenta accreta has the potential to reduce maternal morbidity. However, limited data are available to guide optimal management. In this paper, we will report the case of a 34 years old female, G3P2, admitted in our structure for peripartum hemorrhage because of because of placenta abnormalitie.

Keywords

• peripartum hemorrhage
• placenta accreta
• cesarean delivery
• hysterectomy
• pelvic mri