Abstract
In this case report we present a patient of 39 weeks pregnancy with a placenta accreta and discuss the new possilities of diagnosis of placental masses with respect to the related literature. The aim of our review was to assess the available useful procedures in an attempt to contribute to the decreasing the morbidity of this condition. Twenty-nine years-old gravida 2, para 0 was referred to our hospital at 38 weeks of gestation for planed delivery by cesarien section. She had a history of prior surgical pregnancy termination at 12 weeks of amenorrhea by dilation and curettage. The abnormal placentation was diagnosed during a routine sonographic examination at 22 weeks of gestation. 2D transvaginal ultrasound showed the total placenta praevia and the presence of multiple intraplacental lacunae. The placenta did not detach with gentle traction, so placenta accreta was suspected. Heavy bleeding hemorrage from the placental site induced the decision to perform an emergency hysterectomy. The prenatal diagnosis of placenta accreta before delivery allows multidisciplinary planning and minimize potential maternal or neonatal morbidity and mortality. Grayscale ultrasonography with the use of color Doppler is sufficient to diagnose placenta accreta. The knowlege of the ultrasound markers for placenta accreta is needed for both radiologist and obstetricians-gynecologist.
Highlights
Placenta accreta is a major public health problem due to complications that have a direct impact on the most important reproductive health indicators: maternal morbidity and mortality, perinatal morbidity and mortality
No randomized controlled trials were published. These studies have a number of limitations, including limited generality and a lack of serious statistics. In this case report we present a patient of 39 weeks pregnancy with a placenta accreta and discuss the new possilities of diagnosis of placental masses with respect to the related literature
All the obstetricians and interventional radiologists should be familiar with the risk factors and modalities of diagnosis for placenta acreta due to its potential risk of an emergency situation in obstetrics that puts women’s life in danger through massive hemorrhage
Summary
Placenta accreta is a major public health problem due to complications that have a direct impact on the most important reproductive health indicators: maternal morbidity and mortality, perinatal morbidity and mortality. The reported morbidity rate in placenta accreta is 7-10%, but there are obstetrics units reporting a rate as high as 29% [1, 2]. Existing literature consists predominantly of clinical case-control reports or retrospective studies conducted in single hospitals or in a small number of third level medical institutions using medical records over a limited number of years. These studies have a number of limitations, including limited generality and a lack of serious statistics. In this case report we present a patient of 39 weeks pregnancy with a placenta accreta and discuss the new possilities of diagnosis of placental masses with respect to the related literature. The aim of our review was to assess the available useful procedures in an attempt to contribute to the decreasing the morbidity of this condition
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