Late Angular Pregnancy at 18 Weeks of Gestation with Placenta Accreta: A Case Report and Review of the Literature

Angular pregnancy is a rare obstetric condition characterized by the implantation of the gestational sac in the lateral uterine angle. We report the case of a 30-year-old patient, gravida IV para I, with a history of two spontaneous abortions treated by dilation and curettage and one previous vaginal delivery, presenting to the emergency department with acute pelvic pain and minimal vaginal bleeding at 18 weeks of gestation. Transabdominal ultrasound revealed a non-viable fetus with no cardiac activity with an irregular presentation and suspicion of placenta accreta. An exploratory laparotomy confirmed the diagnosis of a right angular pregnancy complicated by placenta accreta. Surgical management included a hemihysterectomy. The surgery was completed without any further complications.