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Placenta increta after hysteroscopic myomectomy
Emily Mathiesen1, Mark Hohenwalter, Zainab Basir
1Department of Obstetrics and Gynecology, Medical College of Wisconsin Affiliated Hospitals, and the Maternal Fetal Medicine Department, Department of Radiology, and the Pathology Department, Medical College of Wisconsin, Milwaukee, Wisconsin.
Background:
Most cases of abnormal placentation are associated with a history of one or more cesarean deliveries. Uterine leiomyomas and treatment for such a diagnosis are also risk factors for placenta accreta and should be viewed as such.
Case:
A 34-year-old woman underwent a hysteroscopic myomectomy and became pregnant 6 months later. Ultrasonography and magnetic resonance imaging suggested a placenta percreta. Multidisciplinary care allowed for a safe delivery of her neonate and little maternal morbidity.
Conclusion:
Patients with a history of hysteroscopic myomectomy or other uterine leiomyoma treatment are at an increased risk for abnormal placentation. Imaging studies are suggested in such patients to coordinate multidisciplinary care to decrease maternal and fetal morbidity and mortality.
