Key result
Emergency cesarean section and hysterectomy fail to prevent maternal death following uterine rupture and massive hemorrhage.
Why the study?
Abnormal placental adhesion causes severe life-threatening bleeding requiring emergency hysterectomy and is an essential cause of maternal death.
Case Report (n=1)
No
A prior classical hysterotomy markedly increases the risk of placenta accreta spectrum, highlighting the need for targeted screening and management in tertiary care centers to prevent catastrophic uterine rupture and maternal death.
Underscores lethal risk in placenta percreta despite emergency hysterectomy; leaves open optimal screening and delivery timing in high-risk patients.
Abnormal placental adhesion is often associated with severe life-threatening bleeding, which requires emergency hysterectomy around parturition. Abnormal adhesions of the placenta are an essential cause of maternal death due to bleeding during pregnancy or after parturition. A 39-year-old patient with G2P1IUFD1, who had a history of hypothyroidism and IUFD in the 24th week of pregnancy, had undergone a hysterotomy with classical incision. The patient with a gestational age of 36 W + 4D called emergency 911, complaining of pain and sweating, and was taken to the maternity Ward of the hospital. The patient was triaged at level 1 with features of restlessness, headache, cold sweat, cephalgia, no bleeding, discharge, and contractions in the examination. The possibility of placenta accreta was raised in the MRI, and the emergency cesarean section was performed at 12:35. About 3–4 L of blood due to uterine rupture before the C/S were removed after opening the abdomen. A baby was born with thick meconium and an Apgar score of 2.10 at 5 min. Approximately 20% of the placenta had a decollement, and there was a tear of about 4–5 cm in front of the fundus of the uterus in the place of the previous classic incision. The patient suffered cardiac arrest three times, and finally, despite the measures taken, resuscitation was not successful, and the Patient expired. Today, placentas with abnormal adhesions are increasing due to the frequent use of C/S and abnormal uterine incisions. One way to reduce this critical complication is to avoid C/S without indication.
No takes yet. Share an insight, caveat, or question.
Hadinejad et al. (2026) conducted a case report in Pregnant woman, 39 years old, history of prior classical hysterotomy and intrauterine fetal demise, hypothyroidism and diabetes, advanced maternal age, with placenta percreta complicated by uterine rupture and massive hemorrhage (n=1). Emergency cesarean section and subsequent cesarean hysterectomy was evaluated on Maternal survival after emergency cesarean section and hysterectomy for placenta percreta complicated by uterine rupture and massive hemorrhage. Emergency cesarean section and subsequent hysterectomy failed to prevent maternal death in a 39-year-old woman with placenta percreta complicated by uterine rupture and massive hemorrhage.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: