Placenta accreta syndrome (PAS) is rare in first-trimester abortions with an unscarred uterus. It is this rarity that makes diagnosis and management difficult and challenging. This is a case report of a multigravid with an early incomplete abortion complicated by PAS (placenta increta) manifesting as an ill-defined hypervascular uterine cavity mass on transvaginal ultrasound, with decreasing trends of serum beta-human chorionic gonadotropin. PAS was successfully diagnosed preoperatively, and an uneventful hysterectomy was performed. A curettage that could potentially lead to catastrophic hemorrhage was prevented. This case highlights the diagnostic dilemma in early trimester PAS, the importance of early accurate diagnosis, and a good correlation with ancillary diagnostics to provide prompt and appropriate management.
Pregnancy ; Placenta Accreta ; Ultrasonography, Doppler, Color

Advanced abdominal pregnancy is associated with catastrophic outcomes for both mother and fetus. Because it is rare, it is often misdiagnosed and the surgery, often unplanned, may end up with uncontrollable hemorrhage and injury to abdominal structures during placental removal. A case of a 21-year-old G1P0, 34 weeks gestation, who presented as a bleeding placenta previa but diagnosed intraoperatively as abdominal pregnancy with a live baby with congenital anomalies, with complete removal of the placenta and with good maternal outcome is presented. This report highlights the pitfalls in diagnosis and stresses the importance of team management, adherence to good surgical principles, and timely operative decisions to ensure a successful outcome when preoperative evaluation is not possible.
Pregnancy, Ectopic

An 18-year-old, G0, with primary amenorrhea consulting because of a rapidly enlarging abdominal mass was diagnosed with Swyer syndrome or 46 XY pure gonadal dysgenesis and subsequently underwent staging laparotomy for mixed germ cell tumor (dysgerminoma and yolk sac tumor) arising from her dysgenetic gonad. Bleomycin, etoposide, cisplatin regimen for three to four cycles was planned but the patient was lost to follow-up. A prompt evaluation of her amenorrhea and a timely gonadectomy could have averted the development of malignancy.

Human ; Female ; Amenorrhea ; Gonadal Dysgenesis ; Swyer Syndrome ; Mixed Germ Cell Tumor Of Ovary