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Elective robotic hysterectomy for placenta accreta spectrum in the second trimester: Case report
Amro Elfeky1, Mary Ann Son1, Camila Paiva1
1Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, NY, 11219, United States.
Background:
A scheduled pre-viable hysterectomy is a treatment option for women with early diagnosed placenta accreta spectrum who do not wish future fertility. A minimally invasive hysterectomy with pregnancy in situ for placenta accreta spectrum has not been previously reported.
Case:
A patient with evidence of placenta accreta spectrum on prenatal imaging underwent an elective robot-assisted laparoscopic hysterectomy at 16 weeks of gestation. The procedure was uncomplicated and she was discharged on postoperative day 1. Pathology was consistent with placenta percreta.
Conclusion:
Robot-assisted laparoscopic hysterectomy with pregnancy in situ is feasible in a patient with placenta accreta spectrum in the second trimester.
Teaching Points:
1. Early diagnosis of placenta accreta spectrum is important for surgical planning and management. 2. We present a technique for minimally invasive hysterectomy in a patient with placenta accreta spectrum diagnosed before viability.
