Placenta previa and increta into the lower segment myometrium and cervical canal with uterine artery aneurysm in pregnant women with no uterine scar
Objective. To demonstrate cases of uterine artery aneurysm and placenta increta into the internal cervical os in pregnant women who have no uterine scar.Tskhai V.B., Glyzina Yu.N., Yametov P.K., Levanova E.A., Lobanova T.T., Gritzaeva E.A., Chubko M.A.
Material and methods. Two clinical cases of placenta previa and increta into the internal cervical os were analyzed in multiparous women. The diagnosis was confirmed by ultrasound, magnetic resonance imaging (MRI), and histological examination.
Results. According to ultrasound and MRI, placenta previa and increta into the cervical canal was diagnosed in two cases. One female patient who was 29 years of age and had given birth twice underwent a caesarean section at 32 weeks’ gestation; the other patient who was aged 37 years and had given birth once had the section at 38 weeks. Intraoperatively, in both cases, the placenta was located on the anterior wall of the uterus; there was uterine artery aneurysm (10×14 and 10×12 cm in size) and deep placental penetration into the cervical canal, which required hysterectomy; the total blood loss was 900 and 1700 ml, respectively.
Conclusion. Timely diagnosis of placenta previa and increta is one of the most important components of the prevention of severe obstetric complications. Multiparous women with placenta previa are likely to develop uterine artery aneurysm and placenta increta not only into the area of the lower cervical segment, but also in the cervical canal.
Keywords
placenta previa and increta
placental ingrowth into the cervix
uterine artery aneurysm
ultrasound diagnosis
magnetic resonance imaging
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Received 01.02.2018
Accepted 02.03.2018
About the Authors
Tskhay, Vitaly B., MD, professor, head of the Department of Perinatology, Obstetrics, and Gynecology, Faculty of General Medicine, V.F. Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, Ministry of Health of the Russian Federation.660022, Russia, Krasnoyarsk, Str. P. Geleznyaka 1. Tel.: +79232872134. E-mail: tchai@yandex.ru
Glizina, Yulia N., PhD, assistant of perinatology, Department of Perinatology, Obstetrics, and Gynecology, Faculty of General Medicine, V.F. Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, Ministry of Health of the Russian Federation; head of the maternity department, Krasnoyarsk Territorial Clinical Center for Maternal and Child Care. 660074, Russia, Krasnoyarsk , Akad. Kirenskogo str. 2a. Tel.: +79029245599. E-mail: glizinajulia@mail.ru
Yametov, Pavel K., assistant of the Department of Perinatology, Obstetrics, and Gynecology, Faculty of General Medicine, V.F. Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, Ministry of Health of the Russian Federation. 660022, Russia, Krasnoyarsk, P. Geleznyaka str. 1. Tel.: +79509782527. E-mail: mail.rurwap@mail.ru
Levanova, Ecaterina A., obstetrician-gynecologist, Krasnoyarsk Territorial Clinical Center for Maternal and Child Care.
660074, Russia, Krasnoyarsk, Akad. Kirenskogo str. 2a. Tel.: +79676124806. E-mail: ekkovaleva@rambler.ru
Lobanova, Tatyana T., the heard of ultrasound diagnostic department, Krasnoyarsk Territorial Clinical Center for Maternal and Child Care.
660074, Russia, Krasnoyarsk, Akad. Kirenskogo str. 2a. Tel.: +79131974868. E-mail: oufd_pc@pericentr.ru
Gritsaeva, Elena A., assistant of Department of Perinatology, Obstetrics, and Gynecology, Faculty of General Medicine, V.F. Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, Ministry of Health of the Russian Federation; obstetrician-gynecologist, Krasnoyarsk Territorial Clinical Center for Maternal and Child Care.
660074, Russia, Krasnoyarsk, Akad. Kirenskogo str. 2a. Tel. +79832803160. E-mail: rsr1987@yandex.ru
Chubco, Marina A., physician radiologist of the Department of Radiology, Krasnoyarsk Territorial Clinical Center for Maternal and Child Care.
660074, Russia, Krasnoyarsk, Akad. Kirenskogo str. 2a. Тel. +79509885588 E-mail: chubco-marina@yandex.ru
For citations: Tskhai V.B., Glyzina Yu.N., Yametov P.K., Levanova E.A., Lobanova T.T., Gritzaeva E.A., Chubko M.A. Placenta previa and increta into the lower segment myometrium and cervical canal with uterine artery aneurysm in pregnant women with no uterine scar. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2019; (5): 194-9. (in Russian)
http://dx.doi.org/10.18565/aig.2019.5.194-199
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