A RARE CASE OF PLACENTA ACCRETA SPECTRUM WITH PLACENTA PREVIA IN UTERUS DIDELPHYS

Placenta accreta spectrum is a spectrum of disorder ranging from abnormally adherent to deeply invasive placental tissue in the myometrium. The most important risk factor is reported to be placental previa. It is a potentially life threatening obstetric condition that requires a multidisciplinary approach. Uterus didelphys is a mullerian duct anomaly; it arises from complete non fusion of mullerian ducts that result in two entirely separate hemi uteri, two cervices and single or double vagina. The population prevalence is reported to be 0.3% to 3%.It is associated with obstetric complications that include miscarriage, preterm birth and malpresentation. The coexistence of PAS with uterus didelphys is extremely uncommon. Here we present a rare case of 22 year old G3P1LA1 34.5 weeks of gestation with previous LSCS diagnosed with placenta accreta spectrum with placenta previa. Patient was referred to our tertiary care center from district hospital Jalna in view of bleeding per vaginum. Patient was undiagnosed antenatally to have uterus didelphys, which was observed intraoperatively and managed with cesarean hysterectomy