Title : First trimester placenta accreta with myoma in a nullipara: A case report
Abstract:
Detection of placenta accreta spectrum (PAS) disorder in the first trimester is rare and challenging, and a consensus on its diagnostic criteria is lacking. When left undetected, it may lead to obstetrical hemorrhage that may necessitate hysterectomy. This is a case of a 35-year-old G2P0 (0020) with persistent vaginal bleeding after completion curettage for an incomplete abortion. Transvaginal sonography showed an endometrial echogenic mass with cystic spaces with abundant color flow. Assessment was postpartum hemorrhage secondary to retained secundines and multiple myoma uteri. On hysteroscopic resection of the retained secundines, profuse bleeding led to hemorrhagic shock, hence, hysterectomy was performed. Histopathology showed placenta accreta. The case highlights the possibility of placenta accreta in the first trimester and the need for a diagnostic consensus for its detection. Prompt diagnosis is essential for timely intervention and proper patient counseling, including the possibility of hysterectomy if all other conservative methods fail.
