Managing Placenta Accreta Spectrum with Prophylactic Uterine Artery Embolization: A Case Report
Abstract:
The Placenta accreta spectrum (PAS) encompasses several conditions including placenta accreta, increta, and percreta. These conditions are characterized by abnormal placental attachment and invasive growth into the uterine wall, often resulting from defects in the endometrial–myometrial interface and inadequate decidualization at sites of previous uterine scars. This case report highlights the importance of early and proactive intervention with vessel embolization in managing PAS. A 26-year-old female with a history of lower segment cesarean section (LSCS) was diagnosed with placenta accreta. A multidisciplinary approach was employed to manage her condition. The patient underwent an elective cesarean section combined with bilateral internal iliac artery embolization. The removal of an invasive placenta is associated with a high risk of massive blood loss during the peripartum period. Prophylactic intraoperative uterine artery embolization (UAE) significantly mitigated this risk by reducing blood loss associated with the removal of the invasive placenta. For patients with placenta accreta who wish to preserve their fertility, UAE is considered a safer and more effective option. The use of UAE as a preventive measure before or during delivery helps manage bleeding complications and supports better outcomes in the management of PAS.
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