Atypical presentation of placenta percreta post-partum-a conservative surgical approach

Authors

  • Mannava Sai Tejaswi Department of Obstetrics and Gynecology, Amrita Institute of Medical Sciences, Kochi, Kerala, India http://orcid.org/0000-0003-1585-4036
  • Rajashree Menon Department of Obstetrics and Gynecology, Amrita Institute of Medical Sciences, Kochi, Kerala, India http://orcid.org/0000-0003-4349-2706
  • Paladugu Vinya Department of Obstetrics and Gynecology, Amrita Institute of Medical Sciences, Kochi, Kerala, India http://orcid.org/0000-0002-4073-5330
  • Riju Ramachandran Department of Surgery, Amrita Institute of Medical Sciences, Kochi, Kerala, India http://orcid.org/0000-0002-2773-5950
  • Shobha Nair Department of Obstetrics and Gynecology, Amrita Institute of Medical Sciences, Kochi, Kerala, India
  • Radhamany K. Department of Obstetrics and Gynecology, Amrita Institute of Medical Sciences, Kochi, Kerala, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20222327

Keywords:

Pregnancy, Female, Placenta Accreta, Placenta diseases, Placenta

Abstract

We report our experience with an atypical presentation of placenta percreta, presenting as a mass-like bulge in the uterine fundus. A hemodynamically stable young lady status-post preterm delivery at 26 weeks was referred to our center on the third post-partum day after multiple failed attempts at removal of a retained placenta. Magnetic resonance imaging (MRI) showed an atypical fibroid with part of an adherent placenta. Uterine artery embolization was done prophylactically. After a failure at removal under USG guidance, a diagnostic laparoscopy revealed an 8x6 cm highly vascular mass in the fundus extending to the right cornua with intact serosa, possibly placenta percreta. The procedure converted to laparotomy and the mass removed. Histopathology confirmed a placenta percreta. However, the neonate admitted at the referring hospital expired on day 14 due to sepsis. Post-partum adherent placenta in the fundal region on MRI can mimic an atypical fibroid.

Author Biographies

Mannava Sai Tejaswi, Department of Obstetrics and Gynecology, Amrita Institute of Medical Sciences, Kochi, Kerala, India

Department of Obstetrics and Gynecology

Rajashree Menon, Department of Obstetrics and Gynecology, Amrita Institute of Medical Sciences, Kochi, Kerala, India

Department of Obstetrics and Gynecology

Paladugu Vinya, Department of Obstetrics and Gynecology, Amrita Institute of Medical Sciences, Kochi, Kerala, India

Department of Obstetrics and Gynecology

Riju Ramachandran, Department of Surgery, Amrita Institute of Medical Sciences, Kochi, Kerala, India

Department of General Surgery

Shobha Nair, Department of Obstetrics and Gynecology, Amrita Institute of Medical Sciences, Kochi, Kerala, India

Department of Obstetrics and Gynecology

Radhamany K., Department of Obstetrics and Gynecology, Amrita Institute of Medical Sciences, Kochi, Kerala, India

Department of Obstetrics and Gynecology

References

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Jauniaux E, Ayres-de-Campos D, Langhoff-Roos J, Fox KA, Collins S. FIGO Placenta Accreta Diagnosis and Management Expert Consensus Panel. FIGO classification for the clinical diagnosis of placenta accreta spectrum disorders. Int J Gynaecol Obstet. 2019;146(1):20-24.

Toguchi M, Iraha Y, Ito J, Makino W, Azama K, Heianna J et al. Uterine artery embolization for postpartum and postabortion hemorrhage: a retrospective analysis of complications, subsequent fertility and pregnancy outcomes. Jpn J Radiol. 2020;38(3):240-7.

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Published

2022-08-29

Issue

Section

Case Reports