Successful organ-preserving surgical treatment of cicatricial pregnancy in the first trimester: case report

Placenta accreta is a life-threatening condition in the first trimester. Its diagnosis is complicated due to lack of diagnostic criteria. The paper highlights importance of early diagnosis for sparing treatment with preservation of reproductive function. Сase report: patient B., 30 years old, has a 4 pregnancies in anamnesis. During the third pregnancy, a fetal egg was localized in an uterine scar, and vacuum aspiration was performed without excision of the scar itself. The fourth pregnancy led to repeated deep implantation into the scar tissue areа. Сurrent pregnancy is fifth. According to the ultrasound data, a fetal egg implanted in the uterine niche was visualized in the first trimester (6 weeks). Considering a high risk of critical pregnancy complications (placenta percreta, uterine rupture, massive bleeding, hysterectomy), it was decided to carry out conservative treatment at this stage of pregnancy. Laparoscopy and resection of the uterine niche with the fetal egg were performed using bilateral temporary clamping of the internal iliac arteries. Histological examination confirmed the first-trimester placenta accreta Incidence of placenta accreta is constantly increasing due to higher number of abdominal deliveries. If a high risk of severe chorionic invasion is diagnosed, the pregnancy termination in a conservative way should be considered to prevent disability of a woman and to preserve her reproductive function KEYWORDS: placenta accreta, implantation of a fetal egg into an uterine scar, a therapeutic approach in the first trimester of pregnancy. FOR CITATION: Kayumova A.V., Melkozerova O.A., Mikhel'son A.A., Semyonov Yu.A., Kosovtsova N.V. Successful organ-preserving surgical treatment of cicatricial pregnancy in the first trimester: case report. Russian Journal of Woman and Child Health. 2025;8(2):128–132 (in Russ.). DOI: 10.32364/2618-8430-2025-8-2-6