Placenta accreta in a referred post hysterotomy case: a bold step into the unknown

Placenta accreta spectrum encompasses a range of pathological adherence of placenta and causes significant maternal and neonatal morbidity and mortality. With the increase in the number of cesarean deliveries over the last few decades, there has been an 8 fold increase in the incidence of placenta accreta. The single most important risk factor reported in about half the cases of PAS disorders is placenta previa. Management involves a standardized approach with a comprehensive multidisciplinary care team accustomed to management of placenta accreta. We discuss a rare case of a patient who underwent hysterotomy in an outside hospital and was referred to our tertiary care centre as atonic PPH. Undiagnosed antenatally and at the time of hysterotomy, she was diagnosed as a case of placenta accreta on exploration at our institute and was surgically managed