Placenta Accreta Spectrum with Antepartum Haemorrhage in a 34-Year-Old Multigravida: A Comprehensive Obstetric Case Study

Abstract

Placenta Accreta Spectrum (PAS) is a significant obstetric condition defined by aberrant placental adhesion to the uterine wall caused by partial or complete lack of the decidua basalis. It is one of the most common causes of severe obstetric haemorrhage and contributes considerably to maternal morbidity and mortality globally. PAS has become more common in recent decades, owing primarily to an increase in caesarean section deliveries. Early detection and interdisciplinary treatment are critical for better maternal and newborn outcomes. This case study features a 34-year-old multigravida woman who was admitted at 29 weeks and 3 days of gestation with painless vaginal bleeding that suggested antepartum haemorrhage. The patient had undergone one previous lower segment caesarean section. Ultrasonography and colour Doppler imaging revealed features consistent with the placenta accreta spectrum, such as placental lacunae, loss of the retroplacental hypoechoic zone, and enhanced placental vascularity. The patient was treated conservatively, with close maternal and foetal monitoring, blood transfusion preparation, and multidisciplinary care provided by obstetricians, anaesthesiologists, neonatologists, nursing experts, and blood bank workers. The example emphasizes the necessity of prenatal diagnosis, close monitoring, early intervention, and specialist nursing care in managing high-risk pregnancies complicated with PAS. Early detection allowed for the extension of pregnancy while maintaining maternal and foetal stability. This paper emphasizes the critical role of obstetric nurses in monitoring, counselling, emergency readiness, and delivering comprehensive care to women with obstetric difficulties.