First Trimester Post-Abortal Placenta Increta: A Case Report

The objective of this report is to present a case of a 30-year-old, Gravida 3 Para 1 (1021) who had persistent vaginal bleeding post dilatation and curettage due to missed abortion at 11 weeks gestational age.  Differential diagnosis included retained secundines, gestational trophoblastic neoplasia, uterine arteriovenous malformation, and placental accrete syndrome.  This could be differentiated by beta human chorionic gonadotrophic hormone and transvaginal ultrasound.  What made the case interesting is the dilemma in the diagnosis.  In a case of persistent vaginal bleeding after curettage and with a history of cesarean delivery, one will initially think of placenta accrete syndrome.  But then, initial diagnostic tests pointed out to uterine arteriovenous malformation.  Due to the dilemma of the service team in clinching the diagnosis for a single disease entity, pelvic magnetic resonance imaging with contrast was done revealing a possible placenta accreta, but cannot totally rule out vascular tumor.


Marion Ariadne

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