Maternal death at 28 weeks gestation due to vascular rupture of placenta accreta

AJOG global reports Pub Date : 2025-08-27 DOI:10.1016/j.xagr.2025.100562

Khaoula Magdoud MD , Ons Hmandi MD , Sana Menjli MD , Ines Ben Hassen MD , Imen Labidi MD , Eya Azouz MD , Bilel Arfaoui MD , Hassine Saber Abouda MD

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Abstract

Placenta accreta spectrum (PAS) is becoming increasingly common and is associated with significant morbidity and mortality. Prenatal diagnosis and timely referral to centers have been shown to improve outcomes. We present a case of maternal death at 28 weeks of gestation due to massive internal bleeding caused by the rupture of abnormal blood vessels from placenta accreta. The diagnosis of PAS was suspected by morphological ultrasound at 23 weeks of gestation. Expectant management was decided for this patient since she had no children. The patient was transported to the emergency room at 28 weeks of gestation after having a sudden loss of consciousness without other signs (no pelvic pain, no metrorrhagia). After preliminary assessment, maternal death was noted. Hemoperitoneum associated with a placental vascular rupture was found at the autopsy. In the absence of a therapeutic consensus, this case highlights the challenges in managing pregnant women with suspected PAS disorders in the second trimester.

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妊娠28周时因胎盘增生血管破裂导致产妇死亡

胎盘增生谱（PAS）正变得越来越普遍，并与显著的发病率和死亡率相关。产前诊断和及时转诊到中心已被证明可以改善结果。我们提出一个病例的产妇死亡在妊娠28周由于大量内出血引起的异常血管破裂胎盘增生。在妊娠23周时通过形态学超声检查怀疑PAS的诊断。由于该患者无子女，故决定对其进行准治疗。患者在妊娠28周时突然失去意识，无其他体征（无盆腔疼痛，无出血），被送往急诊室。经过初步评估，注意到产妇死亡。在尸检中发现伴有胎盘血管破裂的腹膜出血。在缺乏治疗共识的情况下，本病例强调了在妊娠中期管理疑似PAS障碍的孕妇所面临的挑战。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

AJOG global reports Endocrinology, Diabetes and Metabolism, Obstetrics, Gynecology and Women's Health, Perinatology, Pediatrics and Child Health, Urology

CiteScore

1.20

自引率

0.00%

发文量