Placenta praevia increta with caesarean section scar invasion.

INTRODUCTION

Placenta increta refers to the placenta invading the myometrium. It is a rare but life-threatening condition. The incidence of placenta increta ranges widely from 1 in 540 to 1 in 93,000 deliveries; in Poland it is approximately 0.2% of all deliveries. The occurrence of placenta praevia increta is much lower and accounts for 0.001% to 0.05% of cases. However the frequency of this condition is steadily increasing.

CASE REPORT: Placenta praevia was diagnosed in an ultrasound examination at 20 weeks' gestation in a multipara who had previously delivered by caesarean section. The invasion of the placental vessels into the caesarean section scar was observed in a Colour Doppler scan. The patient was admitted for a planned caesarean section at 36 weeks' gestation and invasion of the vessels into the caesarean scar was confirmed. Because of uncontrolled hemorrhage, a total abdominal hysterectomy was performed. The patient had an uneventful recovery and was discharged well on the fourth postoperative day with a healthy infant.

CONCLUSIONS

Early antenatal detection of placenta praevia increta and planning the surgical intervention tailored to available resources and the patient's expectations result in reducing the number of postpartum maternal, as well as neonatal complications.