DIAGNOSIS AND MANAGEMENT OF A CASE OF PLACENTA PERCRETA IN THE FIRST TRIMESTER OF PREGNANCY: A CASE REPORT

The continuous increase of Cesarean Deliveries is causing a parallel increase in cesarian scar pregnancy and its complications especially placenta accreta spectrum disorders.Placenta percretais rarely diagnosed in the first trimester, and leads often to hysterectomy.In this case report, we report the case of an arab woman of 30-years-old with a surgical history of two cesarean sections.A placenta percreta was discovered following minor vaginal spotting after two months of amenorrhea.We present the imaging methods used for the diagnosis of placenta percreta in the first trimester of pregnancy, as well as the radiological aspect in ultrasound examination, especiallygeographic placental lacunae with poorly defined edges, turbulent flow on color Doppler, interruption of the line between the myometrium and the bladder.We also present our therapeutic strategy which consisted of delivery of the placenta associated with hypogastric arteries ligature and the adjunction of an intra-muscular injection of Methotrexate.This therapeutic strategy made it possible to preserve subsequent fertility.