{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T22:12:57Z","timestamp":1778278377950,"version":"3.51.4"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2024,12,27]],"date-time":"2024-12-27T00:00:00Z","timestamp":1735257600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction and clinical importance:<\/jats:title>\n                    <jats:p>Placenta previa (PP) is characterized by abnormal placental placement in the lower uterine segment, obstructing the cervical opening. Placenta previa totalis (PPT) occurs when the placenta completely covers the internal cervical os. This condition can lead to placenta accreta spectrum (PAS), where the placenta adheres abnormally to the uterine wall, complicating separation. PAS is reported in approximately 0.2 % of pregnancies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation:<\/jats:title>\n                    <jats:p>This report concerns a case of a 28-year-old woman at 35 weeks gestation presented with painless vaginal bleeding and contractions. She had a history of five cesarean sections. Ultrasound revealed PPT with suspected placenta percreta, alongside multiple false knots and blood lakes in the placenta. A vertical uterine incision allowed for the delivery of a 2700-g male fetus, with APGAR scores of 9\/10 and 10\/10. Following massive hemorrhage, an abdominal hysterectomy was performed. The patient was discharged on postoperative day four in stable condition, and the infant was also discharged healthy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical discussion:<\/jats:title>\n                    <jats:p>PAS poses significant maternal risks, necessitating early diagnosis and meticulous surgical planning. Management strategies, including feeder vessel ligation and conservative approaches, aim to minimize hemorrhage. Hysterectomy remains a critical intervention in cases of uncontrollable bleeding, with postoperative care focused on hemodynamic stabilization and pain management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This paper emphasizes effective communication, timely decision-making, and adherence to massive hemorrhage protocols in managing obstetric emergencies like PAS. In addition, routine screening during second-trimester ultrasounds for high-risk pregnancies and further prospective clinical trials are needed to enhance diagnostic and management strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2024.110804","type":"journal-article","created":{"date-parts":[[2024,12,29]],"date-time":"2024-12-29T10:01:28Z","timestamp":1735466488000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Lessons learned from a case of placenta previa totalis complicated by placenta accreta spectrum: Importance of timely decision-making"],"prefix":"10.1097","volume":"126","author":[{"given":"Ibrahim","family":"Fathallah","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Al-Baath University, Homs, Syria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayham","family":"Qatza","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Hama University, Hama, Syria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abd Alrhman","family":"Alajrd","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Al-Baath University, Homs, Syria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Majd","family":"Al-Ali","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Tishreen University, Lattakia, Syria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"issue":"4","key":"R1-153-20260508","doi-asserted-by":"crossref","first-page":"409","DOI":"10.17085\/apm.20076","article-title":"Management of massive hemorrhage in preg-nant women with placenta previa","volume":"15","author":"Park","year":"2020","journal-title":"Anesth Pain Med (Seoul)."},{"issue":"7","key":"R2-153-20260508","article-title":"Managing placenta Accreta and massive hemorrhage: a case report on anesthetic and surgical interventions","volume":"16","author":"Laranjo","year":"2024","journal-title":"Cureus"},{"issue":"11","key":"R3-153-20260508","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2019-031193","article-title":"Epidemiology of placenta previa accreta: a systematic review and meta-analysis","volume":"9","author":"Jauniaux","year":"2019","journal-title":"BMJ Open"},{"issue":"3","key":"R4-153-20260508","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1016\/j.ajog.2020.01.044","article-title":"Minimizing surgical blood loss at cesarean hysterectomy for placenta previa with ev-idence of placenta increta or placenta percreta: the state of play in 2020","volume":"223","author":"Kingdom","year":"2020","journal-title":"Am. J. Obstet. Gynecol."},{"key":"R5-153-20260508","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.ejogrb.2021.02.001","article-title":"What we know about placenta accreta spectrum (PAS)","volume":"259","author":"Liu","year":"2021","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"issue":"5","key":"R6-153-20260508","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1097\/JS9.0000000000000373","article-title":"The SCARE 2023 guideline: updating consensus surgical CAse REport (SCARE) guidelines","volume":"109","author":"Sohrabi","year":"2023","journal-title":"Int. J. Surg."},{"key":"R7-153-20260508","article-title":"A case of placenta percreta managed with sequential embolisation procedures","volume":"2018","author":"Armstrong-Kempter","year":"2018","journal-title":"Case Rep. Obstet. 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Can."},{"key":"R11-153-20260508","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijscr.2024.109774","article-title":"Managing Placenta Accreta Spectrum: A case report on combining conservative care with uterine angioembolization.","volume":"119","author":"Teymoordash","year":"2024","journal-title":"Int J Surg Case Rep."},{"issue":"5","key":"R12-153-20260508","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1111\/j.0001-6349.2005.00504.x","article-title":"Surgical uterine devascularization for placenta accreta: immediate and long-term follow-up","volume":"84","author":"Verspyck","year":"2005","journal-title":"Acta Obstet. Gynecol. Scand."},{"issue":"3","key":"R13-153-20260508","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1002\/ijgo.12308","article-title":"Leaving the placenta in situ versus conservative and radical surgery in the treatment of placenta accreta spectrum disorders","volume":"140","author":"Kutuk","year":"2018","journal-title":"Int. J. Gynaecol. 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