Unexpected uterine body placenta accreta spectrum with placenta previa in a subsequent pregnancy after uterine artery embolization: a case report

BACKGROUND: A subsequent pregnancy after uterine artery embolization (UAE) raises several concerns, one of which is placenta accreta spectrum (PAS). Placenta previa is the strongest risk factor for PAS, which is most likely to occur in the lower uterine segment. PAS without placenta previa (i.e., uterine body PAS) is considered relatively rare. CASE PRESENTATION: A 35-year-old woman, gravida 2 para 1, had undergone UAE for postpartum hemorrhage due to uterine atony after vaginal delivery in her previous pregnancy. She developed placenta previa during her subsequent pregnancy and was therefore evaluated for PAS in the lower uterine segment. On the basis of examination findings, we considered PAS to be unlikely. During cesarean section, we found that the placenta was not detached from the uterine body, and the patient was determined to have uterine body PAS. Ultimately, a hysterectomy was performed. CONCLUSIONS: PAS can occur in a subsequent pregnancy after UAE. When a subsequent pregnancy after UAE is accompanied by placenta previa, it is important to maintain a high index of suspicion of uterine body PAS without being misled by the presence of placenta previa.