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Federación Mexicana de Ginecología y Obstetricia, A.C.

2021, Number 02

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Ginecol Obstet Mex 2021; 89 (02)

Placenta accreta in a twin pregnancy. Case report and literature review

Norzagaray-Barreras CE, Oseguera-Torres LF, Guizar-Solorio AR, Cárdenas-Valdez JC

Language: Spanish
References: 31
Page: 141-150
PDF size: 418.19 Kb.


ABSTRACT

Background: The main risk factor for placental accretion is the presence of placenta previa with a history of previous caesarean section; twin pregnancy is associated with a higher probability of PP. Pregnancies conceived with assisted reproduction techniques, especially through in vitro fertilization, are more probability to develop accretism; the proportion of multiple pregnancy has increased due to ART. Ultrasonography has a sensitivity of 91% and specificity 97% to diagnose placental accretion. Accreted placenta is less likely to be prenatal detected in twins.
Objective: To report the first case of twin pregnancy complicated with accreted placenta with successful management, in Mexican literature.
Clinical case: A 20-year-old patient, with 2 previous cesarean sections, with a bicorial twin pregnancy. At 36 weeks, the ultrasound showed two placentas, one anterior with ultrasound data of placenta increta / percreta. A planned caesarean hysterectomy was performed leaving both placentas in situ, the two hypogastric arteries were ligated, a bleeding of 1200mL was estimated, no hemotransfusion was required. She was discharged on the third postoperative day, without complications. The histopathology reported placenta increta.
Conclusiones: The high morbidity related to a twin pregnancy associated with placental accretion reported in published cases, requires a careful diagnosis, to detect morbid adherence, especially if there are risk factors, and thus prepare for the termination of pregnancy to reduce complications.


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