An unusual case of Uterine window revealing the placenta: A Diagnostic dilemma between Scar dehiscence and the Placenta Accreta Spectrum.

Abstract

Uterine scar dehiscence, or the "uterine window," is a complication of a repeat cesarean section. Preterm delivery, caesarean sections performed more than twice in the past, or less than a 24-month interval between deliveries are all connected with an increased risk. The terms Placenta Accreta Spectrum (PAS) and uterine scar dehiscence are frequently used interchangeably. A 25-year-old unbooked pregnant woman, gravida 3 para 2 live 1, presented to OPD at 37 weeks gestation. During the intraoperative phase, we discovered a silent scar dehiscence with partially visible placental lobes under the intact serosa mimicking the Placenta Accreta Spectrum. A lower-segment caesarean section was performed, and the placenta was totally separated. After the cesarean incision was closed, the myometrial defect was corrected. It is crucial to distinguish it from disorders in the Placenta Accreta Spectrum, as prenatal imaging can be deceptive if not performed with the requisite expertise to distinguish between the two conditions. This distinction will inform the treatment strategies for uterine dehiscence and PAS disorders, which are distinct.