Placenta increta at 13 weeks of gestation masquerading as molar pregnancy: A case report

Abstract

Placenta increta is an uncommon yet clinically significant complication that can result in maternal morbidity and mortality. It is primarily seen during the third trimester. There have been very few reports of it being discovered in the first trimester of pregnancy. However, the presentation was even more unique in our patient who was initially diagnosed with molar pregnancy via pelvic sonogram.

Case presentation

A 30-year-old G4P3, with three previous C-sections, presented with per vaginal bleeding at 13 weeks and 4 days of gestation. Pelvic sonogram suggested molar pregnancy, which led to a suction and curettage. During the planned procedure, severe uncontrolled hemorrhage ultimately resulted in a total abdominal hysterectomy. Subsequent histopathology revealed placenta increta with less than 50 % invasion of villi and trophoblasts into the myometrium, thus giving us our final diagnosis.

Conclusion

This case showcases how placenta increta can be found as early as first trimester- rare though it may be. This unique condition, which could result in major morbidity, should be among the differential diagnoses when unexpectedly profuse hemorrhage is encountered in a woman with previous C-section scar.