Protrusion of placental tissue through the cervical os as an unusual presentation of placenta accreta: A case report.

Introduction: Abnormal placentation commonly occurs in women with a history of uterine surgery or placenta previa. Placenta accreta spectrum can occur in the setting of lesser-known risk factors and anatomical locations.

Case: A 41-year-old woman (G6P4014) at 18 weeks of gestation without major risk factors was diagnosed with a placenta accreta after presenting for desired termination of pregnancy. On examination, placental tissue was found to be protruding through the cervical os and this was confirmed by magnetic resonance imaging (MRI). Management included pregnancy termination with intracardiac potassium chloride injection, uterine artery embolization, and a total abdominal hysterectomy.

Conclusion: Protruding cervical tissue should raise suspicion for placenta accreta. Appropriate evaluation and surgical planning should be performed to ensure a safe delivery.