A CASE OF POSTPARTUM HEMORRHAGE DUE TO PLACENTA ACCRETA DIAGNOSED BY ANATOMOPATHOLOGY EXAM

Abstract

Placenta accreta is a rare but potentially life-threatening condition in which the placenta invades the myometrium of the uterus. It is more common in women with a history of previous cesarean delivery, placenta previa, or uterine surgery. The diagnosis of placenta accreta can be challenging and is often madeintraoperatively or postoperatively. A 36-year-old gravida 4 para 3 woman presented with postpartum hemorrhage due to placenta accreta that was diagnosed by an anatomopathology exam. The management of postpartum hemorrhage typically involves several steps to stabilize the patient and control bleeding. In this case, the patient was resuscitated with intravenous fluids and blood transfusions, given uterotonic medications, and underwent emergency laparotomy to remove her uterus. An anatomopathology exam confirmed the diagnosis of placenta accreta, which had not been suspected during the initial assessment. The patients postoperative course was uneventful, and she was discharged on the seventh postoperative day. The management of PPH due to placenta accreta requires a multidisciplinary approach involving obstetricians, anesthesiologists, hematologists, and interventional radiologists. The initial management of PPH involves resuscitation and stabilization of the patient. The next step is to control bleeding by uterine massage and administration of uterotonic agents. If bleeding persists despite uterine massage and administration of uterotonic agents, surgical intervention should be considered, which includes uterine artery embolization, hysterectomy, and conservative management. The choice of surgical management depends on the severity of bleeding, hemodynamic stability, and the extent of placental invasion. Early diagnosis and management of placenta accreta are essential for the prevention of adverse outcomes, and a multidisciplinary approach is crucial for the successful management of this condition.