DOI:10.18643/gieu.2017.73
"> DOI:10.18643/gieu.2017.73
"> DOI:10.18643/gieu.2017.73
"/> Placenta accreta at 16 weeks associated with polyfibromatosis and consecutive hysterectomy. A case report
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GINECOeu13(2)73-74(2017)
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Placenta accreta at 16 weeks associated with polyfibromatosis and consecutive hysterectomy. A case report

G. Filipescu, C. Vladu, N. Clim, R. Vladareanu, A. Boiangiu


Abstract: Placenta accreta is defined as an abnormal attachment of the placenta to the uterine wall with abnormal bond of the placental villi through the endometrium, directly into the myometrium. We report a case of a 38-year-old pregnant, gravida 3, para 1, with a previous cesarean delivery 10 years ago and known with uterine polyfibromatosis that presented to our emergency unit at 16 weeks of amenorrhea with diffuse abdominal ache and mild vaginal hemorrhage. The emergency ultrasound examination revealed uterine polyfibromatosis, incomplete miscarriage and suspected abnormal placentation. A dilation and curettage was performed. Due to persistent active vaginal bleeding and to the hemodinamicaly instability of the patient a second emergency ultrasound was performed and revealed a retained, adherent placenta on the anterior uterine wall. Therefore, an emergency laparotomy with abdominal hysterectomy was performed. Histopathology revealed a polyfibromatous uterus and placenta accreta adherent to isthmic fibroid tumors. Abnormal adherent placentation can significantly increase maternal hemorrhagic morbidity, thus when a prenatal diagnosis of placenta accreta is confirmed or suspected, it is necessary to implement a multidisciplinary approach.
DOI:10.18643/gieu.2017.73

Keywords: abnormal placentation, placenta accrete, polyfibromatosis, emergency hysterectomy.

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