SUCCESSFUL CONSERVATIVE SURGICAL MANAGEMENT OF SUSPECTED PLACENTA INCRETA IN A PRIMIGRAVIDA: A CASE REPORT

Abstract

Placenta accreta spectrum (PAS) disorders complicate approximately 0.19% (1 in 533) of pregnancies and are associated with significant maternal morbidity and mortality. More than 90% of cases occur in women with prior cesarean delivery, placenta previa, or previous uterine surgery. Occurrence of placenta increta in a primigravida without identifiable risk factors is therefore exceptionally rare and largely limited to isolated case reports. We report a case of a primigravida at 40+1 weeks of gestation with breech presentation and posterior placenta who underwent elective cesarean section. Intraoperatively, the placenta was found to be abnormally adherent to the posterior uterine wall, and a clinical diagnosis of placenta increta was made. The patient developed massive postpartum hemorrhage requiring multidisciplinary intervention. Conservative surgical measures, including bilateral uterine artery ligation, intrauterine packing, and B-Lynch compression suturing, successfully achieved hemostasis and preserved the uterus. The patient recovered well and resumed normal menstrual cycles on follow-up.