De placenta previa a placenta pércreta, desafío diagnóstico y terapéutico. A propósito de un caso

Placenta previa is defined as placental implantation in the lower uterine segment, fully or partially covering the internal cervical os, which can lead to painless bleeding in the third trimester of pregnancy and increase the risk of preterm birth, placental abruption, and postpartum hemorrhage. Placental accretism is a complication where chorionic villi abnormally invade the myometrium, making it difficult to remove the placenta and causing a massive hemorrhage that requires hysterectomy. We present the case of a 38-year-old patient, IIIG, AI, IC, with a pregnancy of 37 weeks + 1 day. Obstetric ultrasound at 34 weeks showed a total occlusive placenta previa, without placental lacunae, highly vascularized myometrium, and an irregular posterior bladder wall, indicating a high risk of placental accretism. She was hospitalized under strict non-invasive hemodynamic monitoring to plan for the termination of pregnancy.