Case report

28-year-old Singaporean lady, with one previous uncomplicated emergency Caesarean 4 years ago, who was diagnosed with anterior right lateral placenta praevia major during her routine fetal anomaly scan(GA 20wk). A repeat scan at 30 weeks was highly suspicious for placenta accrete spectrum with loss of hypoechoic space measuring 5x4 cms over the previous scar,  increased vascularity and presence of multiple lacunae, and thin overlying myometrium. She presented with fetal demise at 32 weeks.

She had a fetal MRI confirming placenta accreta with area of 6x5 cm at the UV fold and below that, but no involvement of bladder

 

Operative details

EBL 2500 ml of blood, requiring 3 PCTS, remained hemodynamically stable during the surgery.

 Total Surgical time was 130 minutes.

Post surgery recovery

High-dependency Unit  for 18 hours

Post operative recovery was uneventful with adequate pain control

She was discharged on post-operative day 4.