Preoperative computed tomography angiography as a critical tool in the surgical management of conservatively treated placenta accreta spectrum: two case reports.

OBJECTIVES

We present two cases of conservatively managed placenta accreta spectrum (PAS) to highlight the importance of preoperative computed tomography angiography (CTA).

CASE REPORT: Both Case 1 and Case 2 involved patients with PAS who developed complications five months after undergoing conservative management. In Case 1, preoperative CTA revealed engorged and tortuous vessels with contrast extravasation into the uterine cavity. She subsequently underwent surgical evacuation of the retained placenta; however, due to uncontrollable hemorrhage, the procedure was converted to a hysterectomy. In case 2, CTA revealed mildly dilated vessels without evidence of contrast extravasation into the uterine cavity. Surgical evacuation was successfully performed, and the uterus was preserved.

CONCLUSION

Preoperative CTA can provide critical information when managing retained placenta following conservative treatment, aiding clinicians in determining whether hysterectomy is necessary.