Undiagnosed Placenta Accreta Spectrum Before Birth at the Delivery Room Obstetric Emergency in Srinagarind Hospital, Khon Kaen Province: A Case Report
Keywords:
placenta accreta spectrum, obstetric emergency, cesarean section, placenta previa, postpartum careAbstract
Background and Objectives: Spectrum (PAS) was a condition that poses a life-threatening risk to both the mother and the baby. The objective of this study was to provide a guideline for the development of care for pregnant women who were unaware of having placenta accreta before delivery.
Methods: One case study was selected where placenta accreta was not detected before delivery. The patient received care in the delivery unit at Srinagarind Hospital. Data were collected from medical records, delivery reports, and the hospital's information system.
Results: The patient, a 38-year-old married Thai woman in her third pregnancy at 27+2 weeks of gestation, had a history of two previous normal vaginal deliveries. In this pregnancy, she was diagnosed with placenta previa and experienced abnormal vaginal bleeding in the early stages. She was referred from the Chaiyaphum Hospital to the delivery unit at Srinagarind Hospital, Khon Kaen, due to premature rupture of membranes. She was treated with labor-inhibiting medication. After one day of observation in the delivery unit, she experienced strong and frequent uterine contractions with heavy fresh vaginal bleeding. An emergency cesarean section was performed, during which placenta accreta was discovered. An emergency hysterectomy was conducted. Post-operatively, the mother received continued care in the postpartum ward, and the newborn was transferred to the neonatal intensive care unit.
Conclusion: Accurate prenatal diagnosis of placenta accreta and clear guidelines for managing undiagnosed cases of placenta accreta could significantly reduce the incidence of morbidity and mortality in pregnant women.
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