Catastrophic Obstetric Haemorrhage with Placenta Previa Accreta Complicated by Silent Scar Dehiscence : A Case Report

Placenta accreta refers to abnormal p lacental implantation in which the placental villi is attached to the myometrium due to poorly formed or absent decidua basalis. Hence it is more common in the scarred area of the lower uterine segment that does not resist deep penetration by the trophoblast. This may result in complicat ions in the peripartum period such as severe haemorrhage, scar dehiscence and rupture with a need for caesarean hysterectomy. The incidence of p lacenta accreta is rising, primarily because of the rise in caesarean delivery rates.Carefully selected cases with a prenatal u ltrasound diagnosis can be managed conservatively with a multi d isciplinary team which results in good outcomes. But in cases where placenta accreta occurs at the site of a previous cesarean section scar can lead to scar dehiscence or rupture long before the onset of delivery and the outcome may be disasterous. Conclusion: This report describes a patient with placenta previa with (unexpected) accreta who presented with a silent scar dehiscence and torrential haemorrhage.