PMC5768976_01
Ultrasonographic findings of the patient. (a) and (b) Transvaginal ultrasonography at 7-0/7 weeks of gestation. The gestational sacs in the uterus (black arrow) and cervical canal (white arrow) are shown. The plus signs indicate the fetus. The crown-to-rump lengths were 10.6 mm in the intrauterine pregnancy and 5.6 mm in the cervical pregnancy. (c) and (d) Transvaginal ultrasonography at 31-2/7 weeks of gestation. A lower edge of the placenta (black arrow) was 41 mm apart from the internal os of the uterus (white arrow). The presence of a blood flow that connected the internal os and the lower edge of the placenta was observed. No sign of placenta accreta was observed before the cesarean section
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However, despite the discontinuation of progesterone supplementation, the gestational sacs in the cervix and uterus continued to develop and formed yolk sacs (Figs 1a and 1b). The subsequent course of the pregnancy was uneventful until delivery, except for a vasa previa that was detected at 28 weeks of gestation (Figs 1c and 1d).
Macroscopic and histological findings of the uterus. (a) Placental tissues (black arrow) invaded the uterine myometrium (white arrow). (b) The trophoblastic villi (black arrow) invaded the myometrium (white arrow)
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A histological examination of the uterus indicated a total placenta accreta; placental villi had invaded the myometrium (Figs 2a and 2b).