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Ainun Karima
West Nusa Tenggara Academic General Hospital, IndonesiaPresentation Title:
Placenta Previa Accreta: A Case Report on Management of Elective Cesarean Delivery at Tertiary Hospital in West Nusa Tenggara
Abstract
The Incidence and prevalence of placenta accreta and placenta previa has increased due to the increasing numbers of cesarean deliveries. Placenta accreta is one of the most serious complications of pregnancy and is often associated with placenta previa and severe obstetric hemorrhage and one of an important cause of maternal-fetal-neonatal morbidity and mortality. We report the case of a 32-year-old woman who diagnosed with gravida 4 para 2 with two times previous cesarean sections, 1 time abortion, and history of adhesion during her second cesarean section. The diagnosis by ultrasound and followed by cystoscopy examination showed invasion of placental blood vessels to detrusor muscle and submucous of urinary bladder. The decision for elective cesarean section was made and delivery time was at 34+3 weeks of gestation. A 2500g male baby has been delivered, placenta was not removed due to massive bleeding that occurred during the operation and an urgent decision for supra-cervical hysterectomy was taken. Patient admitted to intensive care unit due to severe blood loss during operation and the patient was discharged on the sixth day of postoperative treatment. Pathologies that occur in placental implantation such as placenta previa and placenta accreta are often associated with high maternal-fetal-neonatal morbidity and mortality. Cesarean section with hysterectomy is usually performed between 34-36 weeks of gestation before the time of delivery to await sufficient surfactant in the fetal lungs and limit the possibility of massive bleeding.
Biography
Ainun Karima completed her general practitioner education at Mataram University in 2015 and worked as a general practitioner in remote areas of Lombok until 2022 also became a medical volunteer in the North Lombok area which was affected by the earthquake in 2018. Her interest in the field of obstetrics and gynecology has been since the beginning of her medical education and is now a resident doctor of obstetrics and gynecology at Mataram University.
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