Objective Concurrent
placenta previa and
placenta accreta increase the risk of massive obstetric
hemorrhage. Despite extensive research on the management of
placenta previa (including
placenta accreta, increta, and percreta), the number and quality of previous studies are limited. We present a case of
placenta accreta requiring an induced second-trimester abortion because of premature
rupture of the membranes (PROM). Study Design Case report and review of the literature. Results A 41-year-old female presented at 20 weeks of gestation with
placenta previa and PROM. Ultrasonography revealed
placenta accreta with multiple placental lacunae. She then developed massive hemorrhaging just prior to a planned termination of pregnancy. We performed a
hysterectomy with the intent of preserving life because of the failure of the placenta to detach and blood loss totaling 4,500 mL. Conclusion Previous studies suggest that second-trimester pregnancy terminations in cases of
placenta previa which are not complicated with
placenta accreta do not have a particularly high risk of
hemorrhage. However, together with our case, the literature suggests that
placenta previa complicated with
placenta accreta presents a significant risk of
hemorrhage both during delivery and intraoperatively. Further reports are needed to evaluate the most appropriate treatment options.