Dahiwale Silky, Somalwar Savita, Bhalerao Anuja
Department of Obstetrics and Gynaecology, NKP Salve Institute of Medical Sciences and Research Centre, Nagpur, IND.
Cureus. 2025 Apr 30;17(4):e83253. doi: 10.7759/cureus.83253. eCollection 2025 Apr.
Placenta accreta spectrum (PAS) is a significant obstetric complication characterized by abnormal invasion of the placenta into the uterine wall. It often necessitates a peripartum hysterectomy to prevent life-threatening hemorrhage. This case report highlights a rare presentation of PAS and the subsequent surgical intervention. A 31-year-old (gravida 4, para 1) woman at 26 weeks of gestation presented with abdominal pain. Ultrasonography and MRI revealed signs consistent with retained placenta following an intrauterine fetal death. Despite attempts at manual placental removal, the placenta was adherent, and an emergency hysterectomy was performed due to placenta accreta. The patient had a history of previous cesarean section, which likely contributed to the development of PAS. Intraoperatively, the distorted uterine anatomy further complicated the surgical approach. Hence, this case underscores the importance of early detection of PAS and appropriate surgical intervention to manage the associated risks. Comprehensive preoperative planning and a multidisciplinary approach are crucial to improving outcomes in cases of PAS.
胎盘植入谱系疾病（PAS）是一种严重的产科并发症，其特征是胎盘异常侵入子宫壁。它通常需要在围产期进行子宫切除术以防止危及生命的出血。本病例报告突出了PAS的罕见表现及随后的手术干预。一名31岁（孕4产1）、妊娠26周的女性因腹痛就诊。超声检查和磁共振成像显示与宫内胎儿死亡后胎盘残留相符的征象。尽管尝试手动取出胎盘，但胎盘仍粘连，因胎盘植入而行急诊子宫切除术。该患者有剖宫产史，这可能促成了PAS的发生。术中，子宫解剖结构扭曲使手术入路更加复杂。因此，本病例强调了早期发现PAS及进行适当手术干预以管理相关风险的重要性。全面的术前规划和多学科方法对于改善PAS病例的结局至关重要。
