Uterine Preservation in a Case of Isthmic Placenta Accreta With Massive Obstetric Hemorrhage: A Case Report

Placenta accreta spectrum (PAS) disorders are associated with significant maternal morbidity, often requiring hysterectomy. Conservative management remains controversial but may be considered in selected cases. We report a case of isthmic placenta accreta in a 32-year-old multiparous woman with a prior cesarean section. The patient presented with antepartum hemorrhage and was diagnosed with placenta previa with suspected accreta on magnetic resonance imaging (MRI). An emergency cesarean section was performed following massive hemorrhage. Partial placental removal was achieved, while the adherent isthmic portion was left in situ and managed conservatively with hemostatic sutures. Despite significant intraoperative bleeding requiring transfusion, the patient had a favorable outcome, with complete spontaneous resorption of retained placental tissue over three months. This case highlights the feasibility of conservative management in selected cases of isthmic placenta accreta.