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

Authors

  • 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

DOI:

https://doi.org/10.13181/mji.cr.226011

Keywords:

angular pregnancy, case report, placenta accreta
Abstract viewed: 1035 times
PDF downloaded: 751 times
HTML downloaded: 307 times
EPUB downloaded: 185 times

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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References

Alanbay ?, Öztürk M, Kara?ahin KE, Yenen MC. Angular pregnancy. Turk J Obstet Gynecol. 2016;13(4):218-20. https://doi.org/10.4274/tjod.42402

Society of Gynecologic Oncology; American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine, Cahill AG, Beigi R, Heine RP, Silver RM, Wax JR. Placenta accreta spectrum. Am J Obstet Gynecol. 2018;219(6):B2-16. https://doi.org/10.1016/j.ajog.2018.09.042

Silver RM. Placenta accreta syndrome. Boca Raton: CRC Press, Taylor & Francis Group; 2017.

Silver RM, Barbour KD. Placenta accreta spectrum: accreta, increta, and percreta. Obstet Gynecol Clin North Am. 2015;42(2):381-402. https://doi.org/10.1016/j.ogc.2015.01.014

Jauniaux E, Bhide A, Kennedy A, Woodward P, Hubinont C, Collins S; FIGO Placenta Accreta Diagnosis and Management Expert Consensus Panel. FIGO consensus guidelines on placenta accreta spectrum disorders: prenatal diagnosis and screening. Int J Gynaecol Obstet. 2018;140(3):274-80. https://doi.org/10.1002/ijgo.12408

Aditiawarman, Saroyo YB, Dachlan EG, Sulistyono A, Akbar MIA, Hadijono RS, et al. Placenta accreta spectrum disorder training handbook first edition. Jakarta: Indonesian Placenta Accreta Task Force, Maternal Fetal Medicine Society, Indonesian Society of Obstetrics and Gynecology; 2019.

Putri IF, Ariadi. The relationship between the placenta accreta index (PAI) score and the incidence of placenta accreta in patients giving birth in the Obstetrics Department of RSUP.Dr.M. Djamil Padang. Andalas Obstet Gynecol J. 2018;2(2):78-82. https://doi.org/10.25077/aoj.2.2.78-82.2018

Qatrunnada A, Antonius PA, Yusrawati. [Risk factors and maternal outcomes in placenta accreta in Dr. M. Djamil Padang General Hospital]. Obgynia. 2018;1(2):97-102. Indonesian. https://doi.org/10.24198/obgynia.v1n2.94

Jauniaux E, Chantraine F, Silver RM, Langhoff-Roos J; FIGO Placenta Accreta Diagnosis and Management Expert Consensus Panel. FIGO consensus guidelines on placenta accreta spectrum disorders: Epidemiology. Int J Gynaecol Obstet. 2018;140(3):265-73. https://doi.org/10.1002/ijgo.12408

Nakatsuka E, Mimura K, Endo M, Miyake T, Kakigano A, Matsuzaki S, et al. Conservative management for adherent placenta after live birth in angular or interstitial pregnancies: a new entity "angular placenta attachment". Taiwan J Obstet Gynecol. 2020;59(6):975-9. https://doi.org/10.1016/j.tjog.2020.09.033

Kim TH, Lee HH, Chung SH, Yi BH. Term angular pregnancy with placenta accreta. Obstet Gynecol Sci. 2010;53(6):520-4. https://doi.org/10.5468/kjog.2010.53.6.520

Fitri DR, Mutiara H. [G2P1A0 41 years age with placenta accrete]. J Medula Unila. 2017;7(2):37-41. Indonesian.

Garmi G, Salim R. Epidemiology, etiology, diagnosis, and management of placenta accreta. Obstet Gynecol Int. 2012;2012:873929. https://doi.org/10.1155/2012/873929

D'Antonio F, Palacios-Jaraquemada J, Timor-Trisch I, Cali G. Placenta accreta spectrum disorders: Prenatal diagnosis still lacks clinical correlation. Acta Obstet Gynecol Scand. 2018;97(7):773-5. https://doi.org/10.1111/aogs.13374

Rac MW, Dashe JS, Wells CE, Moschos E, McIntire DD, Twickler DM. Ultrasound predictors of placental invasion: the placenta accreta index. Am J Obstet Gynecol. 2015;212(3):343.e1-7. https://doi.org/10.1016/j.ajog.2014.10.022

Diouf A, Thiam O, Ndour K, Gueye M, Ndiaye MD, Niang D, et al. Management of placenta percreta. A case report. O J Gynecol Obstet Res. 2020;2:01-4. https://doi.org/10.36811/ojgor.2020.110012

Oyelese Y, Smulian JC. Placenta previa, placenta accreta, and vasa previa. Obstet Gynecol. 2006;107(4):927-41. https://doi.org/10.1097/01.AOG.0000207559.15715.98

Timmermans S, van Hof AC, Duvekot JJ. Conservative management of abnormally invasive placentation. Obstet Gynecol Surv. 2007;62(8):529-39. https://doi.org/10.1097/01.ogx.0000271133.27011.05

Alanis M, Hurst BS, Marshburn PB, Matthews ML. Conservative management of placenta increta with selective arterial embolization preserves future fertility and results in a favorable outcome in subsequent pregnancies. Fertil Steril. 2006;86(5):1514.e3-7. https://doi.org/10.1016/j.fertnstert.2006.02.128

Palacios-Jaraquemada JM. One-step conservative surgery for abnormal invasive placenta (placenta accreta-increta-percreta) [Internet]. GlowmCom.:263--71. Available from: https://www.glowm.com/pdf/PPH_2nd_edn_Chap-31.pdf.

Committee Opinion No. 712: Intrapartum Management of Intraamniotic Infection. Obstet Gynecol. 2017;130(2):e95-101. https://doi.org/10.1097/AOG.0000000000002236

Fan SR, Liu P, Yan SM, Peng JY, Liu XP. Diagnosis and management of intraamniotic infection. Maternal-Fetal Medicine. 2020;2(4):223-30. https://doi.org/10.1097/FM9.0000000000000052

Montelongo EM, Blue NR, Lee RH. Placenta accreta in a woman with Escherichia coli chorioamnionitis with intact membranes. Case Rep Obstet Gynecol. 2015;2015:121864. https://doi.org/10.1155/2015/121864

Pabinger I, Fries D, Schöchl H, Streif W, Toller W. Tranexamic acid for treatment and prophylaxis of bleeding and hyperfibrinolysis. Wien Klin Wochenschr. 2017;129(9-10):303-16. https://doi.org/10.1007/s00508-017-1194-y

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 2024Dec.21];31(2):126-31. Available from: https://mji.ui.ac.id/journal/index.php/mji/article/view/6011

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Section

Case Report/Series
Abstract viewed = 1035 times
PDF downloaded = 751 times HTML downloaded = 307 times EPUB downloaded = 185 times

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