Placenta accreta - a difficult but significant diagnostic and therapeutic challenge in obstetrics - a case report

Background: Placenta accreta spectrum (PAS) disorders are characterized by abnormal placental adherence and invasion into the uterine wall. They most commonly occur in women with a history of cesarean deliveries and represent an increasingly common iatrogenic condition in modern obstetrics. Case presentation: We report the case of a 40-year-old woman with a history of three cesarean sections, admitted at 31 weeks of gestation due to suspected PAS. Imaging confirmed placental invasion at the site of the uterine scar. At 35 weeks, due to the onset of preterm labor, a scheduled cesarean delivery was performed with preoperative placement of ureteral stents and internal iliac artery balloons. Intraoperative hemorrhage necessitated a peripartum hysterectomy. A male neonate was delivered in good condition and required only brief respiratory support. Conclusion: This case highlights the importance of early diagnosis, imaging surveillance, and multidisciplinary planning in the management of PAS to reduce maternal morbidity. Reducing the rate of cesarean deliveries remains a key preventive strategy.