Speakers - 2026

Title: An Unusual Site of Placental Implantation: Placenta infiltrating Uterine Myoma

Abstract

Normal placental implantation occurs in the decidua basalis of the endometrium of the uterus and is seen in 99.96% of uncomplicated pregnancies. Placenta accreta spectrum (PAS) is rare, occurring in approximately 0.04% of pregnancies. Even more uncommon is placenta accreta infiltrating a myoma uteri, with no established incidence due to its rarity.

This a case of a 38-year-old G3P1 (1022) with a known submucous myoma who presented with profuse vaginal bleeding. During pregnancy, prenatal ultrasounds documented the myoma. She was admitted during the second trimester for management of a spontaneous abortion.  Incomplete placental delivery occurred, requiring completion curettage. Forty-seven days later, she was readmitted due to loss of consciousness secondary to profuse vaginal bleeding. Transvaginal ultrasound suggested submucous myoma, though uterine arteriovenous malformation was also considered. The patient subsequently underwent a total abdominal hysterectomy, where the histopathology report revealed placenta accreta in a leiomyoma. This case highlights the rarity of placenta accreta within a submucous myoma and the diagnostic challenges it poses, as imaging findings may mimic other conditions such as uterine arteriovenous malformation. It underscores the importance of recognizing patient-specific risk factors and maintaining awareness of atypical presentations in obstetric practice.