Placenta accreta spectrum disorders in the first trimester: a systematic review

López, Julieth Alexandra Guzmán; Gutiérrez‐Sánchez, Luz Ángela; Monsalve, Gabriel David Pinilla; Timor‐Tritsch, I. E.

doi:10.1080/01443615.2022.2071151

Cited by 4 publications

(1 citation statement)

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“…In 22.49% of the cases included in the study by Guzmán López et al, they presented ultrasonographic signs of a C-section scar-implanted pregnancy. It is important that, in half of the cases, the diagnosis of PAS was achieved only by histological evaluation and that only in 21.15% of the cases the diagnosis was defined using ultrasound techniques [32].…”

Section: Discussionmentioning

confidence: 99%

Life-Threatening Obstetrical Emergency: Spontaneous Uterine Rupture Associated with Placenta Percreta in the First Trimester of Pregnancy—Case Report and Literature Review

Amza,

Loghin,

Vâlcea

et al. 2024

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Background: The greatest risk for the occurrence of the placenta accreta spectrum (PAS) is represented by uterine scars, which most frequently result after cesarean sections. Uterine rupture is a rare condition and appears mainly in the third trimester of pregnancy. The association between these two conditions is extremely rare in the first trimester of pregnancy. Methods: We performed a systematic review of abnormal placental adhesions and spontaneous uterine ruptures in the first trimester of pregnancy. We also reported a case of spontaneous uterine rupture in a 12-week pregnancy that presented with massive hemoperitoneum and hemorrhagic shock. Results: A 33-year-old patient with two previous cesarean sections, at the twelfth week of pregnancy at the time to this visit to the emergency room, presented with syncope and intense pelvic–abdominal pain. A clinical examination and ultrasound scan established the diagnosis of hemoperitoneum and hemorrhagic shock. Surgical exploration was performed, uterine rupture was identified, and hemostasis hysterectomy was necessary. The histopathological results showed placenta percreta. There have been eight reported cases of spontaneous uterine rupture in the first trimester of pregnancy associated with PAS. In these cases, it was found that 62.5% of the patients had undergone at least one cesarean section in the past; in 75% of the cases, hysterectomy was performed; and, in 87.5% of the cases, the presence of placenta percreta was confirmed. Conclusions: A high rate of cesarean sections determines the increase in the incidence of placenta accreta spectrum disorders. The possible life-threatening complications caused by this pathology can be observed in early pregnancies.

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Section: Discussionmentioning

confidence: 99%