Recurrent severe placenta increta at 8 weeks of gestation in a twin pregnancy following uterus-conserving surgery for prior placenta accreta spectrum disorder
Objective: We describe herein our experience of employing a hysterectomy and prophylactic internal iliac artery balloon occlusion (IIABO) strategy for the management of recurrent severe placenta increta at 8 weeks in a twin pregnancy following uterus-conserving surgery for prior placenta accreta spe...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-11-01
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| Series: | Taiwanese Journal of Obstetrics & Gynecology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1028455920302394 |
| _version_ | 1818151772076638208 |
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| author | Min-Min Chou Jia-Chun Yuan Yaw-An Lu Sheng-Wei Chuang |
| author_facet | Min-Min Chou Jia-Chun Yuan Yaw-An Lu Sheng-Wei Chuang |
| author_sort | Min-Min Chou |
| collection | DOAJ |
| description | Objective: We describe herein our experience of employing a hysterectomy and prophylactic internal iliac artery balloon occlusion (IIABO) strategy for the management of recurrent severe placenta increta at 8 weeks in a twin pregnancy following uterus-conserving surgery for prior placenta accreta spectrum (PAS) disorder. Case report: A 40-year-old woman with a history of uterus-conserving surgery for PAS disorder underwent transvaginal ultrasound evaluation at 8 weeks of pregnancy, which showed a dichorionic/diamniotic pregnancy with viable embryos of a crown-rump length of 1.65 cm and 2.03 cm, respectively. Many irregularly-shaped grade 3+ lacunae were observed, and color Doppler imaging revealed diffuse intraplacental and perihypervascularity. A total abdominal hysterectomy was performed at 10 weeks, with an estimated blood loss of 1275 mL. Placenta increta was confirmed by histopathologic examination. Conclusion: The high rate of recurrence of PAS disorder in a subsequent pregnancy should be discussed following an antenatal diagnosis of PAS disorder with patients who may be considering uterine conservation in order to retain the option of a future pregnancy. |
| first_indexed | 2024-12-11T13:44:08Z |
| format | Article |
| id | doaj.art-c86521b6082a4e21a8452d508ac6ee1c |
| institution | Directory Open Access Journal |
| issn | 1028-4559 |
| language | English |
| last_indexed | 2024-12-11T13:44:08Z |
| publishDate | 2020-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Taiwanese Journal of Obstetrics & Gynecology |
| spelling | doaj.art-c86521b6082a4e21a8452d508ac6ee1c2022-12-22T01:04:37ZengElsevierTaiwanese Journal of Obstetrics & Gynecology1028-45592020-11-01596956959Recurrent severe placenta increta at 8 weeks of gestation in a twin pregnancy following uterus-conserving surgery for prior placenta accreta spectrum disorderMin-Min Chou0Jia-Chun Yuan1Yaw-An Lu2Sheng-Wei Chuang3Corresponding author. Center for High Risk Pregnancy and Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, China Medical University Hospital, 2 Yude Road, Taichung, 40447, Taiwan. Fax: +886 4 22086970.; Center for High Risk Pregnancy and Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, China Medical University Hospital, Taichung, TaiwanCenter for High Risk Pregnancy and Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, China Medical University Hospital, Taichung, TaiwanCenter for High Risk Pregnancy and Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, China Medical University Hospital, Taichung, TaiwanCenter for High Risk Pregnancy and Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, China Medical University Hospital, Taichung, TaiwanObjective: We describe herein our experience of employing a hysterectomy and prophylactic internal iliac artery balloon occlusion (IIABO) strategy for the management of recurrent severe placenta increta at 8 weeks in a twin pregnancy following uterus-conserving surgery for prior placenta accreta spectrum (PAS) disorder. Case report: A 40-year-old woman with a history of uterus-conserving surgery for PAS disorder underwent transvaginal ultrasound evaluation at 8 weeks of pregnancy, which showed a dichorionic/diamniotic pregnancy with viable embryos of a crown-rump length of 1.65 cm and 2.03 cm, respectively. Many irregularly-shaped grade 3+ lacunae were observed, and color Doppler imaging revealed diffuse intraplacental and perihypervascularity. A total abdominal hysterectomy was performed at 10 weeks, with an estimated blood loss of 1275 mL. Placenta increta was confirmed by histopathologic examination. Conclusion: The high rate of recurrence of PAS disorder in a subsequent pregnancy should be discussed following an antenatal diagnosis of PAS disorder with patients who may be considering uterine conservation in order to retain the option of a future pregnancy.http://www.sciencedirect.com/science/article/pii/S1028455920302394HysterectomyInternal iliac artery balloon occlusionRecurrent placenta accreta spectrum disorderUterine artery embolizationTwin pregnancy |
| spellingShingle | Min-Min Chou Jia-Chun Yuan Yaw-An Lu Sheng-Wei Chuang Recurrent severe placenta increta at 8 weeks of gestation in a twin pregnancy following uterus-conserving surgery for prior placenta accreta spectrum disorder Taiwanese Journal of Obstetrics & Gynecology Hysterectomy Internal iliac artery balloon occlusion Recurrent placenta accreta spectrum disorder Uterine artery embolization Twin pregnancy |
| title | Recurrent severe placenta increta at 8 weeks of gestation in a twin pregnancy following uterus-conserving surgery for prior placenta accreta spectrum disorder |
| title_full | Recurrent severe placenta increta at 8 weeks of gestation in a twin pregnancy following uterus-conserving surgery for prior placenta accreta spectrum disorder |
| title_fullStr | Recurrent severe placenta increta at 8 weeks of gestation in a twin pregnancy following uterus-conserving surgery for prior placenta accreta spectrum disorder |
| title_full_unstemmed | Recurrent severe placenta increta at 8 weeks of gestation in a twin pregnancy following uterus-conserving surgery for prior placenta accreta spectrum disorder |
| title_short | Recurrent severe placenta increta at 8 weeks of gestation in a twin pregnancy following uterus-conserving surgery for prior placenta accreta spectrum disorder |
| title_sort | recurrent severe placenta increta at 8 weeks of gestation in a twin pregnancy following uterus conserving surgery for prior placenta accreta spectrum disorder |
| topic | Hysterectomy Internal iliac artery balloon occlusion Recurrent placenta accreta spectrum disorder Uterine artery embolization Twin pregnancy |
| url | http://www.sciencedirect.com/science/article/pii/S1028455920302394 |
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