Unusual imaging findings of placenta accreta resulting in early hysterectomy in first trimester—Two case reports

Conventional and conservative management of placenta accreta is two ends of a single continuum: A report of three cases and literature review

“…Conventionally, the option of treatment for aggressive placentation has been associated with hysterectomy because of the potentially high risk of postpartum hemorrhage. It is a possible causal link between all the developed surgical complications including injuries abutting critical structures, massive blood transfusions, DIC, and substantial death rates . Over the last decade, the process of management has altered from existing conventional approach to avoid leaving any portion of the placenta in utero, to a more conservative concept of leaving the placenta in situ.…”

First Trimester Placenta Accreta: A Rare Clinical Entity and Diagnostic Dilemma

“…The patient underwent an emergency hysterectomy, which confirmed placenta increta post-operatively (14). Liao et al described the use of laparoscopic assisted vaginal hysterectomy for their patient with placenta accrete at 9 weeks gestation although it was complicated with bladder injury intra-operatively (12). Uterine rupture due to a placenta percreta as early as 7th week gestation has also been reported as a rare complication of AIP in the first trimester.…”

“…In comparison, magnetic resonance imaging (MRI) was reserved for patients with posterior praevia at later gestational age or when ultrasound findings were equivocal for abnormal placentation (11). Liao et al successfully demonstrated unusual ultrasonography and MRI findings in two patients in the first trimester who subsequently underwent uterine artery embolisation (UAE) and hysterectomy (12).…”

“…Liao et al also reported the use of UAE in their patient who diagnosed to have placenta increta at first trimester. But, it was complicated with massive bleeding 4 months after UAE and emergency hysterectomy was performed (12). Other reports of conservative management for AIP were mainly in the second or third trimester of pregnancy (5).…”

Rotura uterina durante el segundo trimestre de gestación asociado a placenta percreta: presentación de un caso y revisión de la literature

“…[20,[22][23][24][25][26] La mayoría utilizamos la ecografía como método diagnostico principal visualizando líquido libre. Por otra parte, las imágenes por ultrasonido asociado a Doppler color, podrían ser capaces de identificar anomalías en adhesión y de invasión de la placenta en el miometrio y órganos adyacentes como vejiga.…”