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
INTRODUCTION: Trauma is known to be a causative factor of mortality in pregnancy. However, splenic injuries are atypical in pregnancy. In this case report, we discuss a novel approach using splenic artery embolization to manage a severe form of splenic injury in pregnancy. CASE PRESENTATION: A 35-year-old multigravida presented at 28 weeks of gestation. She had sustained grade V splenic injury and was treated with splenic artery embolization. She continued her pregnancy up to term following the treatment. DISCUSSION: Splenic artery embolization should be considered as an alternative to laparotomy in managing severe forms of splenic injury in pregnancy.
