Noida: A 36-year-old woman who endured more than 10 hours with a retained placenta after delivering a premature baby survived after doctors at a Noida hospital diagnosed a rare combination of pregnancy complications during emergency surgery.The woman had delivered a 1.7kg premature baby boy at another hospital, but the placenta — the organ that supplies oxygen and nutrients to the baby during pregnancy — failed to come out naturally after childbirth. Doctors made several attempts to remove it, but were unsuccessful. Nearly 10 hours later, at around 3am , she was referred to another hospital for emergency treatment.When surgeons operated, they found that the placenta had grown abnormally deep into the wall of the uterus instead of separating after delivery, a condition known as placenta accreta spectrum (PAS). The rare condition can lead to severe, life-threatening bleeding if the placenta is forcibly removed.The surgery revealed another rare finding.“The woman had a unicornuate uterus, a congenital condition in which only one half of the uterus develops normally,” said Dr Ruchi Srivastava, director, obstetrics and gynaecology, Sharda Care Healthcity.According to doctors, the combination of PAS and a unicornuate uterus is extremely rare, with only a handful of such cases documented worldwide.The woman had a history of three previous premature deliveries between six-and-a-half and seven-and-a-half months of pregnancy. In all three previous cases, the placenta had failed to separate naturally and had to be removed manually, making her latest pregnancy particularly high risk.During the operation, she developed massive postpartum haemorrhage — excessive bleeding after childbirth. Doctors performed an emergency hysterectomy, removing the uterus to stop the bleeding and save her life.“This was one of the most challenging obstetric emergencies due to the patient’s repeated history of retained placenta and the rare uterine abnormality. Early recognition, quick surgical decisions and seamless teamwork helped us save the mother’s life while ensuring the best possible outcome for the baby. Such high-risk pregnancies should always be managed at centres equipped with advanced surgical and critical care facilities,” Srivastava said.According to doctors, many women with a unicornuate uterus remain unaware of this condition because it often causes no obvious symptoms and may only come to light during investigations for recurrent pregnancy loss, preterm deliveries, infertility, or complications during pregnancy.“It can usually be detected through detailed pelvic ultrasound, 3D ultrasound, MRI, or during specialised evaluation by a gynaecologist. Early diagnosis is crucial as it allows obstetricians to closely monitor pregnancy, anticipate potential complications, and plan timely interventions. In this case, the coexistence of a unicornuate uterus with Placenta Accreta Spectrum was exceptionally rare, making rapid diagnosis, meticulous surgical planning, and multidisciplinary care critical to saving the mother’s life,” a doctor said.
