Focal increta placentomegaly of the posterior nonscarred uterine wall and posterior asynclitic presentation

Abstract

Background: Fetal malpresentations and malpositions are more common in placenta previa and uterine cavity abnormalities.

Aim: To show successful management of focal increta placentomegaly and uterine preservation in primiparous woman.

Case report: We describe posterior low-lying focal increta placentomegaly verified during cesarean section, which is a possible risk factor for persistent posterior asynclitism and consequent mechanical dystocia. In addition to antifibrinolytics and uterotonics, hemostatic compression sutures of the posterior uterine wall were performed with an applied intrauterine balloon, and thus the uterus was preserved in primiparous woman as a definitive therapy.

Conclusion: Timely identified malplacentation as well as adequate medical and surgical measures taken by an experienced team of obstetricians and anesthesiologists can contribute to preservation of the uterus and thus the life of mother and neonate.

Keywords: Cesarean section; Labor presentation; Placenta accreta; Placentation; Postpartum hemorrhage.