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  • Accurate prenatal discrimination of placenta accreta spectrum from uterine dehiscence is necessary to ensure optimal management

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Case report
Accurate prenatal discrimination of placenta accreta spectrum from uterine dehiscence is necessary to ensure optimal management
  1. Theophilus Kofi Adu-Bredu1,
  2. Atta Owusu-Bempah1 and
  3. Sally Collins2
  1. 1Obstetrics and Gynaecology Directorate, Komfo Anokye Teaching Hospital, Kumasi, Ghana
  2. 2Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK
  1. Correspondence to Professor Sally Collins; sally.collins{at}wrh.ox.ac.uk

Abstract

Uterine scar dehiscence with underlying placenta is often misdiagnosed as placenta accreta spectrum both prenatally and intraoperatively due to the absence of myometrial tissue in the area. Misdiagnosis generates obstetric anxiety and results in overtreatment which carries a risk of iatrogenic injury. We present a case of the antenatal diagnosis of uterine dehiscence in a 36-year-old woman with a history of two caesarean deliveries and a low-lying placenta. We further describe the sonographic features useful for differentiating this condition from placenta accreta spectrum in instances where the placenta lies under an area of full thickness uterine scar dehiscence.

  • pregnancy
  • obstetrics and gynaecology
  • ultrasonography
  • radiology
  • materno-fetal medicine

https://doi.org/10.1136/bcr-2021-244286

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    Footnotes

    • Contributors TKA-B performed the ultrasound examination and prepared the initial draft of the manuscript. AO-B was the lead clinician on the case and contributed to the manuscript. SC contributed to prenatal sonographic diagnosis, provided guidance and edited the final manuscript. All authors approved the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.