Unilateral Uterine and Ovarian Arterial Ligations in a Case of Missed Abortion at 12 Weeks of Gestation with Undiagnosed Placenta Accreta

Abstract

Placenta accreta is abnormal placental attachment to the myometrium, and the incidence rate has risen with the increased use of Cesarean sections. First-trimester placenta accreta is a rare, potentially life-threatening condition due to the severe hemorrhage it may cause, necessitating a hysterectomy. We present a case of a 38-year-old woman with a history of two Cesarean section deliveries who developed severe bleeding during curetting due to undiagnosed placenta accreta. Unilateral uterine and ovarian arterial ligations were performed to reduce expected bleeding along with a local resection of the placental implantation site that was invading the old scar. This procedure was effective with fewer complications than traditional procedures and preserved the patient’s fertility.

How many missed abortions are caused by embryonic chromosomal abnormalities and what are their risk factors?

“…As a special type of spontaneous abortion, missed abortions account for 10%–20% of spontaneous abortions, while 25% of women undergo spontaneous abortion ( Practice Committee of the American Society for Reproductive, 2012 ; Shahine and Lathi, 2015 ; Mohammad-Akbari et al, 2022 ). The incidence rate of missed abortions has shown an obvious upward trend in recent years ( Alnafisah and Alalfy, 2018 ; Zhao et al, 2021 ; Torres-Miranda et al, 2022 ), which has seriously affected the physical and mental health of the patients, family, and social happiness.…”