Young AMP, Uribe K, Shaddeau AK. Protrusion of placental tissue through the cervical os as an unusual presentation of placenta accreta: A case report.
Case Rep Womens Health 2021;
31:e00334. [PMID:
34189059 PMCID:
PMC8220340 DOI:
10.1016/j.crwh.2021.e00334]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/08/2021] [Accepted: 06/08/2021] [Indexed: 11/25/2022] Open
Abstract
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.
Placenta accreta can occur in a patient without traditional risk factors.
Placenta acreeta should be considered when protruding cervical tissue is suspected or identified during pregnancy
The role of advanced maternal age in abnormal placentation should be further characterized.
Institutions should utilize a standard screening protocol for abnormal placentation including indications for MRI.
A multidisciplinary approach is critical to optimize maternal safety.
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