Placenta accreta spectrum as a complication of transabdominal cerclage.

Abstract

Cervical cerclage, particularly transabdominal cerclage (TAC), is a last resort surgical procedure to manage cervical incompetence. Despite its high success rate, TAC carries inherent risks and can result in complications. Placenta accreta spectrum (PAS) disorder, a rare iatrogenic condition linked to previous uterine surgeries, especially caesarean sections, poses a significant risk of severe obstetric haemorrhage during delivery, often leading to maternal and neonatal morbidity.This case presents a woman in her 30s with a history of cervical insufficiency who underwent an abdominal cerclage. An uneventful pregnancy ensued, leading to a planned caesarean delivery. However, her subsequent pregnancy was complicated by cerclage erosion, uterine scar dehiscence and ultimately PAS disorder. These complications were confirmed through transvaginal ultrasound and MRI assessments prenatally and on histopathology after birth. A caesarean hysterectomy was performed at 32 weeks due to threatened preterm labour. Both mother and her infant experienced an uncomplicated postpartum and neonatal recovery.