Placenta increta, one type of morbidly adherent placenta, is characterized by entire or partial absence of the decidua basalis, and by the incomplete development of the fibrinoid or Nitabuch’s layer and villi actually invading the myometrium. When the internal os is covered partially or completely by placenta, it is described as a placenta previa. Simultaneously these two complications occurring in a post LSCS scarred uterus is a very rare scenario and anticipated frequently to cause catastrophic obstetric outcome. A 32-years-old woman of second gravida, para 1, with previous history of LSCS 7 years back, with living issue one, admitted in our hospital at 35 weeks 5 days gestation with asymptomatic placenta previa with placenta increta. The case was diagnosed effectively by ultrasonography. Intra-operatively, compression sutures and bilateral uterine artery ligature was tried to control hemorrhage which were failed and a quick decision of caesarean hysterectomy was done. Preserving both ovaries, total hysterectomy was the only option to save the mother in our case. Other options attempting to preserve uterus could have ended up with grave consequences in this case. This was a very rare case of asymptomatic placenta previa with placenta increta in a post LSCS scarred uterus and it was successfully managed by judicious caesarean hysterectomy.
Circumvallate placenta, a morphological abnormality of placenta can be defined as a thickened placenta with a raised margin in an annular shape and it is thought to be the result of a membranous fold of chorion and amnion. A 23-year-old primigravida mother was presented with grossly reduced liquor due to preterm premature rupture of membranes at 32 weeks of gestation. The preterm baby was delivered by emergency caesarean section (category-2 caesarean section). A thorough gross examination of the placenta was done and a thickened circumvallate placenta was noted with a firm white annular margin and normal umbilical cord insertion. Histopathological findings were consistent with the diagnosis of circumvallate placenta. Routine gross examination of placenta is of immense important for better understanding of pregnancy complications due to placental abnormalities like circumvallate placenta.
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