PMC4260288_01
Sonography view of hypoechotic mass in the uterus
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F1
Transvaginal sonography was performed as requested: UT > NI, retrovert uterus, endometrial thickness = 2.6 mm, hypoechotic mass about 8 cm in the lower uterine segment with necrotic change and increased vascularity with low resistance was seen around it [Figure 1].
Uterus with lower segment mass
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F2
Hysterectomy was performed immediately for treatment of hemorrhage-induced hypotension, fluid replacement and packed blood cells and blood products were administered [Figure 2].
Histopathology examination demonstrates trophoblastic invasion into the myometrium
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F3
Definitive pathology of the surgical specimen led to a diagnosis of necrotic and hemorrhagic placental tissue, consistent with placenta previa and placenta increta [Figure 3].
PMC4260288_02
Mixed echo lesion in the uterine cavity
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F4
Uterine mass in the lower segment after pathology shows placenta increta
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F5
A total abdominal hysterectomy was performed [Figure 5].
Histopathology examination demonstrates trophoblastic invasion into the myometrium
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F6
After surgery, BHCG became negative and histopathology reported a retained placenta increta involving the lower uterine segment without atypical trophoblastic cells [Figure 6].