ABSTRACT
Placenta accreta spectrum (PAS) refers to abnormal trophoblast invasion into the myometrium. The global prevalence of PAS is rising as the number of caesarean deliveries increases. PAS is associated with higher rates of maternal morbidity and mortality. Although mainstream management has been caesarean hysterectomy, uterine conservative techniques are also used, such as the extirpative technique, leaving the placenta in situ, the triple-P procedure, embolisation, uterine balloon tamponade and methotrexate medication. This case report describes an innovative yet simple and safe technique, namely partial myometrial resection of the focal adherent placenta. Unlike hysterectomy, this technique can preserve fertility. It was performed on an undiagnosed focal placental accreta during a caesarean section with a routine caesarean section theatre set-up and did not require obstetric follow-up after the patient was discharged. This procedure can be considered an option for managing focal placenta accreta.
ABSTRACT
Guillain-Barré syndrome (GBS) is an autoimmune neurological disorder with unknown aetiology. Given the incidence of GBS is between 1.2 and 1.9 cases per 100,000 people annually [1], it is extremely rare in pregnancy. We report a case with a challenging diagnosis of pre-eclampsia (PET) in a 34-year-old diabetic primigravida who was diagnosed with GBS at 30 weeks of gestation. At her initial presentation, she complained of progressive weakness of her limbs and facial muscles. This was associated with difficulty swallowing. The diagnosis of GBS was made based on electromyography (EMG) and clinical findings. She was managed conservatively with supportive management and was delivered by lower segment caesarean section at 34 weeks of gestation due to rapidly deteriorating liver function tests (LFTs) in the likely setting of PET.
