Placenta accreta in late term abortion with subsequent hysterectomy Placenta acreta en aborto tardío con posterior histerectomía

Abstract

Placenta accreta in early pregnancy is not a common condition but one that should be considered as a severe complication of pregnancy, associated with massive antepartum or intrapartum haemorrhage which can be life-threatening. This study presents the case of a patient with a previous caesarean birth and a second semester scan showing placenta accreta, regarded as an inevitable cause for abortion at 20 weeks of pregnancy. Following cervical ripening and expulsion of the foetus with placental retention and massive bleeding, an emergency subtotal hysterectomy was required with recovery after surgery. The pathology study showed placenta accreta. Abnormal placentation in early pregnancy has seen a marked increase due to the increase in caesareans in recent decades. The main objective of studying this case is to emphasise the importance of early recognition of changes of placentation in the first and second trimesters of pregnancy. In patients with risk factors, a thorough assessment looking for placenta accreta is necessary in order to be able to anticipate complications associated with this pathology and thus have a positive impact on the associated maternal morbidity and mortality.