Placenta accreta spectrum disorder in a primigravida with angular pregnancy: a case report

  • Abarham Martadiansyah Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sriwijaya, Mohammad Hoesin Hospital, Palembang, Indonesia
  • Nuswil Bernolian Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sriwijaya, Mohammad Hoesin Hospital, Palembang, Indonesia
  • Putri Mirani Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sriwijaya, Mohammad Hoesin Hospital, Palembang, Indonesia
  • Peby Maulina Lestari Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sriwijaya, Mohammad Hoesin Hospital, Palembang, Indonesia
  • Citra Dewi Department of Anatomical Pathology, Faculty of Medicine, Universitas Sriwijaya, Mohammad Hoesin Hospital, Palembang, Indonesia
  • Wim Theodorus Pangemanan Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sriwijaya, Mohammad Hoesin Hospital, Palembang, Indonesia
  • Ahmad Kurdi Syamsuri Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sriwijaya, Mohammad Hoesin Hospital, Palembang, Indonesia
  • Muhammad Hatta Ansori Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine Sriwijaya University, Palembang, South Sumatera, Indonesia
  • Cindy Kesty Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sriwijaya, Mohammad Hoesin Hospital, Palembang, Indonesia https://orcid.org/0000-0002-4610-4185
Keywords: angular pregnancy, case report, placenta accreta

Abstract

Placenta accreta spectrum (PAS) is characterized by abnormal invasion of placental tissue into the underlying uterine muscles and has an incidence of 1/533–1/251. The incidence of complications includes uterine rupture (14–29%), PAS (6–10%), and retained placenta or incomplete placenta removal (4%). Here, we described a rare case of PAS and angular pregnancy, including how to diagnose and manage it preoperatively. A 32-year-old primigravida diagnosed at 24 weeks of gestation with a right angular pregnancy was admitted due to preterm premature rupture of membrane (PPROM) with a singleton fetus. We decided to perform hysterotomy because of the PPROM and intrauterine infection. Intraoperatively, we found PAS in the right angular pregnancy; therefore, we performed uterine conservative management with wedge resection on the right uterine fundus. Intraoperative bleeding was 1,600 cc. Histopathological examination revealed placenta increta. The maternal prognosis was good, while the fetus was poor, with an APGAR score of 1/1/0.

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Published
2022-08-31
How to Cite
1.
Martadiansyah A, Bernolian N, Mirani P, Lestari PM, Dewi C, Pangemanan WT, Syamsuri AK, Ansori MH, Kesty C. Placenta accreta spectrum disorder in a primigravida with angular pregnancy: a case report. Med J Indones [Internet]. 2022Aug.31 [cited 2024Feb.21];31(2):126-31. Available from: http://mji.ui.ac.id/journal/index.php/mji/article/view/6011
Section
Case Report/Series