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Mini Chapters | Nursing | India | Volume 14 Issue 4, April 2025 | Rating: 4.8 / 10
Placenta Increta in the Absence of Caesarean History: A Case Report and Literature Review
Deena Mohan E.
Abstract: Background: Placenta increta is an abnormal adherence of the placenta with invasion of chorionic villi into the myometrium. It is classically associated with previous uterine surgery such as caesarean sections. However, rare cases occur in the absence of cesarean history, where other risk factors such as prior curettage, advanced maternal age, or uterine anomalies may play a role. Case Presentation: We report a case of a 34?year?old primigravida with no prior caesarean delivery who presented with persistent vaginal bleeding in the first trimester. Transvaginal ultrasound (TVUS) and magnetic resonance imaging (MRI) suggested abnormal placental implantation in the lower uterine segment. The patient underwent definitive surgical management with total abdominal hysterectomy for life?threatening hemorrhage. Histopathologic examination confirmed placenta increta with invasion of the chorionic villi into a thickened myometrium in the absence of decidual interposition. Discussion: This report is accompanied by a literature review summarizing the epidemiology, imaging features, histopathology, and management options of placenta increta. Although most cases are linked to prior caesarean sections, cases without such history emphasize the importance of considering additional risk factors and maintaining a high index of suspicion in patients with abnormal placentation. Conclusion: Placenta increta may present even in the absence of cesarean history. Early and accurate diagnosis using ultrasound and/or MRI is critical to optimize management and reduce maternal morbidity. Multidisciplinary planning is essential for complex cases, and further studies are needed to refine screening protocols for patients at risk for placenta increta without conventional uterine surgery history.
Keywords: Placenta increta, abnormal placentation, first trimester hemorrhage, uterine invasion, literature review
Edition: Volume 14 Issue 4, April 2025,
Pages: 2293 - 2295