Placenta accreta spectrum disorder complicating a second trimester miscarriage.

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Reproductive Health

Background:

• Placenta accreta spectrum (PAS) is a severe obstetric complication.
• PAS rarely occurs in the second trimester, especially after uterine procedures.
• Previous cesarean section and curettage increase the risk of PAS.

Purpose of the Study:

• To report a rare case of PAS complicating a second-trimester miscarriage.
• To emphasize the importance of recognizing PAS in high-risk pregnancies.
• To highlight the need for prompt intervention to improve maternal outcomes.

Main Methods:

• Case report of a 17-week pregnant patient with a history of C-section and curettage.
• Patient presented with hypovolemic shock due to massive vaginal bleeding after spontaneous abortion.
• Surgical intervention including emergency hysterectomy for morbidly adherent placenta.

Main Results:

• Spontaneous abortion of a 180g fetus occurred, with retained placenta.
• Histopathological examination confirmed placenta accreta.
• Emergency hysterectomy was required due to the severity of PAS.

Conclusions:

• PAS can complicate second-trimester pregnancies, even after uterine procedures.
• Prompt diagnosis and management are critical for maternal survival in PAS cases.
• This case underscores the importance of vigilance for PAS in patients with risk factors.