Maternal death due to placenta percreta: a case report study
摘要
Abnormal placental adhesion is often associated with severe life-threatening bleeding, which requires emergency hysterectomy around parturition. Abnormal adhesions of the placenta are an essential cause of maternal death due to bleeding during pregnancy or after parturition.
Patient presentationA 39-year-old patient with G2P1IUFD1, who had a history of hypothyroidism and IUFD in the 24th week of pregnancy, had undergone a hysterotomy with classical incision. The patient with a gestational age of 36 W + 4D called emergency 911, complaining of pain and sweating, and was taken to the maternity Ward of the hospital. The patient was triaged at level 1 with features of restlessness, headache, cold sweat, cephalgia, no bleeding, discharge, and contractions in the examination. The possibility of placenta accreta was raised in the MRI, and the emergency cesarean section was performed at 12:35. About 3–4 L of blood due to uterine rupture before the C/S were removed after opening the abdomen. A baby was born with thick meconium and an Apgar score of 2.10 at 5 min. Approximately 20% of the placenta had a decollement, and there was a tear of about 4–5 cm in front of the fundus of the uterus in the place of the previous classic incision. The patient suffered cardiac arrest three times, and finally, despite the measures taken, resuscitation was not successful, and the Patient expired.
ConclusionToday, placentas with abnormal adhesions are increasing due to the frequent use of C/S and abnormal uterine incisions. One way to reduce this critical complication is to avoid C/S without indication.