Placenta Accreta at 15 Weeks of Gestational Age and Uterus Preservation with Hysterectomy Abortion

Abstract

Placenta accrete refers to an abnormality of placental implantation in which the anchoring placental villi attached to myometrium rather than decidua resulting in a morbidity adherent placenta. Placenta increta (chorionic villi penetrate into the myometrium) and placenta percreta (chorionic villi penetrate through the myometrium to the uterine serosa or adjacent organs) are related, but more severe, abnormalities of placental implantation. The pathogenesis is primarily attributed to defective decasualization of the implantation site. Placenta accreta has been recognized mostly in the third trimester however may also present in second trimester. It has very heavy, life-threatening hemorrhage to both the mother and fetus. The authors' report a patient with two previous cesarean deliveries, who had been referred for pregnancy termination from Iranian legal medicine organization with 15 weeks of gestational age and placenta acctera. In this patient, uterus preservation and hysterectomy abortion was performed. The case totally lost 1500 cc blood and she was discharged from hospital two days later, with feeling of well-being. We have examined this patient after 1.5 months, she wasn't vaginal bleeding and the uterus was in the pelvic and serum BHCG (with titer) was negative.