Placenta increta during the first trimester of pregnancy is very rare. This report describes two cases of placenta increta that caused prolonged vaginal bleeding after a first-trimester abortion. We were encountered two cases of placenta increta in October 2012 and May 2013. Case I: A 35-year-old patient with continues vaginal bleeding from 2 months after curettage due to missed abortion in the first trimester. The uterus was large, the human chorionic gonadotropin (BHCG) level was 112 mUI/mL and ultrasound showed an echogenic mass in the lower segment of the uterine cavity. She was a candidate for curettage but received hysterectomy because of massive vaginal bleeding. Pathology reported placenta increta. Case II: A 32-year-old patient in the 12th week of gestation with missed abortion. After 6 weeks from curettage, she returned with continues vaginal bleeding, BHCG = 55 mUI/mL and sonography showing mixed echo lesion in the uterine cavity like hydatiform mole. Total abdominal hysterectomy was performed. Pathology reported placenta increta. In patients with a history of recent first-trimester abortion presenting with prolonged vaginal bleeding, uterine mass and low-level BHCG, a diagnosis of abnormal placentaion should be kept in mind.
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http://dx.doi.org/10.4103/2277-9175.145745 | DOI Listing |
Arch Gynecol Obstet
January 2025
Department of Radiology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan.
Purpose: To comprehensively compare the diagnostic ability and inter-reader agreement of magnetic resonance imaging (MRI) findings for predicting massive hemorrhage after cesarean section in patients with placental malposition, aiming to identify the most reliable and objective indicators.
Methods: Totally, 148 consecutive patients with placental malposition underwent MRI and cesarean section at our hospital between January 2014 and July 2021. The patients were divided into massive and non-massive hemorrhage groups.
Pak J Med Sci
January 2025
Shunhe Lin Department of Obstetrics and Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology Pediatrics, Fujian Medical University, Fuzhou, Fujian Province 350001, P.R. China.
Objective: To investigate the correlation between endometriosis (EMs) severity and placenta accreta spectrum (PAS) risk in the subsequent pregnancy.
Method: Clinical records of 2,142 patients who underwent laparoscopic surgery for EMs at Fujian Provincial Maternal and Child Health Hospital from January 2014 to January 2018, who had achieved pregnancy and were delivered, were analyzed. Baseline data, EMs stage, The Revised American Fertility Society (R-AFS) score, levels of serum indexes, and pregnancy and neonatal outcomes were recorded.
Int J Gynaecol Obstet
January 2025
Department of Obstetrics and Gynaecology, Aga-Khan University of Hospital, Nairobi, Kenya.
Placenta accreta spectrum (PAS) poses a significant risk for maternal morbidity and mortality. There is a global rise in incidence of PAS in tandem with an increase in rates of cesarian section. Previous cesarian section and presence of placenta previa are two independent risk factors for development of PAS.
View Article and Find Full Text PDFMedicina (Kaunas)
January 2025
Department of Obstetrics, Gynecology and Reproductive Health, Rutgers New Jersey Medical School, Newark, NJ 07103, USA.
Management of second-trimester placenta accreta spectrum (PAS) is currently center-dependent with minimal evidence-based practices. This study aims to analyze outcomes of hysterectomy as second-trimester active management (AM) versus cesarean hysterectomy as expectant management (EM) in cases of PAS with intraoperative and postoperative outcomes. This study is a retrospective case-control study of patients with a pathology-confirmed diagnosis of PAS managed at a single center over 16 years (2005-2020).
View Article and Find Full Text PDFPurpose: To compare risks of neonatal anomalies and obstetric complications among frozen-thawed embryo transfer (FET), fresh embryo transfer (FreshET), and non-assisted reproductive technology (non-ART) treatments in infertile women.
Methods: This retrospective cohort study analyzed 7378 singleton births (2643 non-ART, 4219 FET, 516 FreshET) from 2013 to 2022. Outcomes were compared using inverse probability weighting regression adjustment, with adjustment for maternal factors.
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