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Title: Placenta accreta spectrum in Primi gravida
e-poster Number: EP 483
Category: Miscellaneous
Author Name: Dr. Nalli Reshma
Institute: Government medical college ,Srikakulam
Co-Author Name:
Abstract :
INTRODUCTION
Placenta accreta spectrum is one of the most dangerous condition in pregnancy and is increasing in incidence because of raise in cesarean section rate . Screening for risk factors and assessing placental location by antenatal ultrasound are essential for timely diagnosis . Although the exact etiology is not known , but the placenta accreta spectrum distorts the uterus and surrounding anatomy and transforms pelvis into high flow vascular state .this condition is a morbid pregnancy condition and is characterized by failure of placental detachment at the time of delivery and may result in life threatening bleeding .Cesarean hysterectomy with the placenta left in situ after the delivery of the fetus is the most common treatment for placenta accreta spectrum
CASE DISCUSSION
A 20 yr old primigravida came to labor room complaining of lower abdominal pain and delivered a Mch at 1:05 am on 20/12/2023 through normal vaginal delivery which is followed by delay in spontaneous separation of placenta for 30 minutes . manual removal of placenta was attempted under general anaesthesia but failed to remove the complete placenta and developed PPH which was refractory to the medical management of PPH . USG was done which showed features suggestive of placenta accreta spectrum suspecting placenta increta. Patient was immediately shifted to OT and peripartum hysterectomy was done as there was refractory PPH . Cut section of uterine specimen has placental tissue in myometrium (placenta increta ) which is a rare presentation in primigravida with no history of any risk factors .
