Placenta previa percreta following caesarean delivery: two case reports

Abstract

Background: Placenta accreta spectrum (PAS) is a clinical term used to describe the abnormal trophoblast invasion into the myometrium of the uterine wall and may enter into the serosa or even into adjacent organs. It is associated with severe obstetric haemorrhage and often requires emergency hysterectomy, which is one of the foremost causes of maternal morbidity and mortality. The vast of these conditions are seen in women with a history of previous caesarean section and placenta previa. Cases: In this study we present two cases of a rare type of PAS, placenta percreta, in women with a history of previous caesarean section (CS). Both instances were diagnosed prenatally, using the method of ultrasound and magnetic resonance imaging. They were scheduled for deliveries by CS, and both were hysterectomized. These diagnoses were confirmed in histopathological findings. Conclusion: Considering sparse published data and absence of well conducted studies, optimal management is still undefined. Caesarean hysterectomy is still the gold standard treatment for placenta accreta spectrum proposed by many societies as an absolute and final treatment.