Placenta accreta spectrum disorder in a primigravida with angular pregnancy: a case report

IF 0.5 Q3 MEDICINE, GENERAL & INTERNAL

Medical Journal of Indonesia Pub Date : 2022-08-31 DOI:10.13181/mji.cr.226011

A. Martadiansyah, Nuswil Bernolian, Putri Mirani, P. M. Lestari, Citra Dewi, W. Pangemanan, A. Syamsuri, Muhammad Hatta Ansori, C. Kesty

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引用次数: 2

Abstract

Placenta accreta spectrum (PAS) is characterized by abnormal invasion of placental tissue into the underlying uterine muscles and has an incidence of 1/533–1/251. The incidence of complications includes uterine rupture (14–29%), PAS (6–10%), and retained placenta or incomplete placenta removal (4%). Here, we described a rare case of PAS and angular pregnancy, including how to diagnose and manage it preoperatively. A 32-year-old primigravida diagnosed at 24 weeks of gestation with a right angular pregnancy was admitted due to preterm premature rupture of membrane (PPROM) with a singleton fetus. We decided to perform hysterotomy because of the PPROM and intrauterine infection. Intraoperatively, we found PAS in the right angular pregnancy; therefore, we performed uterine conservative management with wedge resection on the right uterine fundus. Intraoperative bleeding was 1,600 cc. Histopathological examination revealed placenta increta. The maternal prognosis was good, while the fetus was poor, with an APGAR score of 1/1/0.

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胎盘增生谱系障碍在原始动物与角妊娠:1例报告

胎盘增生谱（PAS）的特征是胎盘组织异常侵入下方的子宫肌，发病率为1/533–1/251。并发症的发生率包括子宫破裂（14-29%）、PAS（6-10%）和胎盘滞留或胎盘切除不全（4%）。在这里，我们描述了一个罕见的PAS和角妊娠病例，包括如何在术前诊断和处理。一名32岁的初产妇在妊娠24周时被诊断为直角妊娠，因早产胎膜早破（PPROM）而入院，胎儿为单胎。由于PPROM和宫内感染，我们决定进行子宫切除术。术中，我们发现右角妊娠有PAS；因此，我们进行了子宫保守治疗，对右侧子宫底进行楔形切除。术中出血1600毫升。组织病理学检查显示胎盘有增量。母体预后良好，胎儿预后较差，APGAR评分为1/1/0。

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

Medical Journal of Indonesia MEDICINE, GENERAL & INTERNAL-

CiteScore

1.00

自引率

20.00%

发文量

审稿时长

24 weeks

期刊介绍： Medical Journal of Indonesia is a peer-reviewed and open access journal that focuses on promoting medical sciences generated from basic sciences, clinical, and community or public health research to integrate researches in all aspects of human health. This journal publishes original articles, reviews, and also interesting case reports. Brief communications containing short features of medicine, latest developments in diagnostic procedures, treatment, or other health issues that is important for the development of health care system are also acceptable. Letters and commentaries of our published articles are welcome.