VP46.34: Placenta previa accreta and short cervix: a case report

Abstract

To describe a case of a patient with a placenta previa accreta with a history of preterm delivery and a short cervix. Placenta accreta is an obstetric entity that has been increasing.The coexistence of this finding, adding to the short cervix and a localisation of the placenta previa in a patient with a history of preterm delivery, confronts us with various debates, regarding what is the ideal moment of termination of pregnancy and the alternatives management. This is a 23-year-old patient with a history of 2 previous Caesarean sections. Those who enter the emergency department with profuse, non-painful vaginal bleeding undergo emergency obstetric ultrasound, evidencing a previous, total, occlusive placenta with ultrasound signs suggestive of placental accretions and a length of the cervix of 19mm. The patient is hospitalised and treatment with hydroxyprogesterone caproate, due to the history of 2 preterm labour, with clinical improvement, progressive bleeding reduction and hemodynamic stability. A Medical Board is held and it is considered to continue management with weekly progesterone caproate, with the goal of bringing the pregnancy to week 34 to reduce the impact of prematurity. Placental accretion represents a challenge for obstetric management and the coexistence of a history of preterm delivery and short cervix implies the integration of preventive management of preterm delivery and the organisation of a multidisciplinary equipment. Supporting information can be found in the online version of this abstract Supporting Information Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.