Perioperative Management of Unexpected Placenta Percreta in a Twin Gestation.

Placenta accreta represents a spectrum of adherent placental anomalies and is an atypical invasion of the placenta. The major predisposing factor is a prior cesarean delivery. Placenta previa is considered an additional risk factor. Twin gestation is increasingly recognized as an independent risk factor for placenta accreta spectrum (PAS) disorders. Currently, immediate hysterectomy is the gold standard treatment. The management of placenta percreta is indeed highly challenging, with significant risks for both the mother and fetus due to the aggressive nature of the condition. We present a case of intraoperative diagnosis of placenta percreta in a 37-year-old woman with twin pregnancy.