Year: 2026 | Month: September | Volume: 13 | Issue: 9 | Pages: 1-7
DOI: https://doi.org/10.52403/ijrr.20260901
Placenta Previa Accreta Meets Malformation: A Surgical Battle - A Case Report
Dr. Kadli Sanjay1, Dr. Divya T K2, Dr. Rajini Uday3
1Postgraduate, Department of Obstetrics and Gynaecology, Sapthagiri Institute of Medical Sciences, Sapthagiri NPS University, Bengaluru, Karnataka, India.
2HOD and Professor, Department of Obstetrics and Gynaecology, Sapthagiri Institute of Medical Sciences, Sapthagiri NPS University, Bengaluru, Karnataka, India.
3Professor, Department of Obstetrics and Gynaecology, Sapthagiri Institute of Medical Sciences, Sapthagiri NPS University, Bengaluru, Karnataka, India.
Corresponding Author: Dr. Kadli Sanjay
ABSTRACT
Placenta accreta spectrum (PAS) is an important cause of severe obstetric haemorrhage and is commonly associated with placenta previa and previous caesarean delivery. The presence of a congenital uterine anomaly can make both diagnosis and surgery more difficult. We report the case of a 25-year-old gravida 3 para 1 living 1 abortion 1 woman with a previous caesarean delivery who presented at 32 weeks with per vaginal bleeding and decreased fetal movements. Fetal distress was noted. Ultrasound showed an anterior low-lying placenta with multiple placental lakes and minimal retroplacental haemorrhage. She was already known to have a bicornuate bicollis uterus with a thick vaginal septum. Emergency caesarean delivery was undertaken. At surgery, the pregnancy was found in the right uterine horn and the anterior placenta was close to the internal os and abnormally adherent to the myometrium. Placental separation was followed by heavy bleeding, and peripartum hysterectomy was required. Massive transfusion and inotropic support were needed, followed by intensive care admission. Inotropes were continued for 12 hours. The mother and neonate subsequently recovered well. Histopathology confirmed placenta accreta and a bicornuate uterus. This case emphasizes the need to recognize PAS from the clinical risk factors and ultrasound findings and to avoid unnecessary attempts at placental separation. Such patients should be managed in a centre with appropriate surgical, anaesthetic, transfusion and critical-care facilities.
Keywords: placenta accreta spectrum; placenta previa; bicornuate uterus; previous caesarean delivery; obstetric haemorrhage; peripartum hysterectomy; case report
[PDF Full Text]