Background Morbidly adherent placenta (MAP) represents a risk factor for a maternal adverse outcome and its incidence continues to rise following the increasing rate of caesarean deliveries. The detection of a pathology of placental adherence in the first trimester is challenging. Transvaginal ultrasound represents (TVUS) a reliable tool for accurate and timely diagnosis. Case We report on a case of MAP in a pregnant woman at 10 weeks of gestation with two prior caesarean deliveries. She presented with abdominal pain and hematometra. The first trimester diagnosis was made with TVUS and confirmed with magnetic resonance imaging. The patient required an urgent hysterectomy. Conclusion Antenatal care in the first trimester in women with a previous cesarean delivery should include a detailed examination of the placenta with TVUS.
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