Cesaerean scar pregnancy complicated with placenta accreta syndrome in the second trimester of pregnancy: a case report

Background:-The aim of this paper is to present a rare case of cesarean scar ectopic complicated with placenta increta in the second trimester of pregnancy. Case Report: A 32 yrs old G3P2L2 with h/o previous 2 cesarean section presented to us with complaints of bleeding per vaginum since 1 month.Per vaginal examination was suggestive of a cystic mass of size 4*5 cm in the right adnexa. Transvaginal ultrasound was suggestive of a hypo echoic mass of size 4.5*3.6 cm in the lower uterine segment with increased vascularity and encroaching the myometrium thereby suggesting placenta increta. Her quantitative βh CG was 322 mIU/ml .Patient underwent a suction and evacuation followed by an exploratory laparotomy for as the size of the mass did not decrease. Obstetric hysterectomy with b/l conservation of fallopian tubes and ovaries was performed as the excision of the lesion lead to massive hemorrhage. Histopathology findings were consistent with products of conception and placenta increta. The patient was discharged on post operative day 12 and her follow up after 2 weeks was uneventful. Conclusion: Cesaerean scar ectopic complicated with morbidly adherent placenta is rare and prompt diagnosis and treatment is needed to avoid catastrophic complications.