Grandelis Anthony, Emont Jordan, Arditi Brittany, Breslin Noelle, Pua Tarah
Department of Obstetrics and Gynecology, Columbia University, New York, New York 10032, USA.
Case Rep Obstet Gynecol. 2024 Nov 29;2024:1329744. doi: 10.1155/crog/1329744. eCollection 2024.
Placenta accreta spectrum (PAS) presents a significant risk of maternal morbidity and mortality, in large part due to the potential for massive hemorrhage at time of delivery. Recently, multiple gestations have been shown to be an independent risk factor for PAS, especially in the setting of other major risk factors. Importantly, antenatal detection of PAS in twin pregnancies has been shown to be suboptimal when compared to singleton pregnancies. Here, we present a case of postpartum hemorrhage and unplanned cesarean hysterectomy due to an undiagnosed placenta increta, which originated from the placenta of a demised twin in the second trimester. This case underscores the importance of thorough prenatal monitoring and evaluation for PAS, especially in multifetal gestations with additional risk factors. It also highlights the need for heightened awareness among healthcare providers to mitigate risks associated with PAS in twin pregnancies. Early detection and multidisciplinary collaboration are crucial in optimizing outcomes for both mothers and infants in such complex obstetric scenarios.
胎盘植入谱系疾病（PAS）存在导致孕产妇发病和死亡的重大风险，很大程度上是因为分娩时可能发生大量出血。最近，多胎妊娠已被证明是PAS的一个独立危险因素，尤其是在存在其他主要危险因素的情况下。重要的是，与单胎妊娠相比，双胎妊娠中PAS的产前检测结果并不理想。在此，我们报告一例因未诊断出的胎盘植入导致产后出血和计划外剖宫产子宫切除术的病例，该胎盘植入起源于孕中期死亡双胎之一的胎盘。该病例强调了对PAS进行全面产前监测和评估的重要性，尤其是在存在其他危险因素的多胎妊娠中。它还突出了医疗保健人员提高认识以降低双胎妊娠中与PAS相关风险的必要性。在这种复杂的产科情况下，早期检测和多学科协作对于优化母婴结局至关重要。
