Morbidly Adherent Placenta in a Primi Gravida Following Incomplete Abortion: A Case Report

Abstract

With rising incidence of caesarean sections and the number of cases of placenta praevia, incidence of morbidly adherent placenta is on the rise. Morbidly adherent placenta, which includes placenta accreta, Increta, and percreta, implies an abnormal implantation of the placenta into the uterine wall. Sonographic markers of placenta accreta can be present as early as the first trimester, such as low uterine implantation of a gestational sac, multiple vascular lacunae within the placenta, loss of the normal hypoechoic retroplacental zone and abnormality of the uterine serosa-bladder interface. Ultrasound has high sensitivity and specificity for the diagnosis of placenta accreta. MRI should be reserved for rare cases in which ultrasound is non-diagnostic. The successful management of placenta accreta includes a team approach with the successful management relying on the prenatal diagnosis of this entity and preparing for the surgical management. Antenatal diagnosis and management in a tertiary care centre helps to reduce maternal and neonatal morbidity and mortality. 1 We present a patient in whom the antenatal diagnosis of morbidly adherent placenta was missed due to lack of antenatal care and presented as second trimester spontaneous incomplete abortion.