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This Author published in this journals
All Journal Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia)
Agustinus Gusti
Siloam Hospitals Labuan Bajo, West Manggarai Nusa Tenggara Timur
Health Professions Medicine & Pharmacology Public Health

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Multidisciplinary Management of Placenta Accreta Spectrum in a Rural Indonesian Hospital Wim Pratama Wijaya; Agustinus Gusti; Michael Reiner Wangania; Firman Nugroho; Maya Permatasari Suyata
Indonesian Journal of Obstetrics and Gynecology Volume 14. No. 2 April 2026
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v14i2.2445

Abstract

ABSTRACT Objective: To describe the challenges of diagnosing and managing Placenta Accreta Spectrum (PAS) in a rural setting, particularly when referral to a specialized center is not feasible. Methods: Case report. We report a case of PAS managed in a resource-limited rural hospital at Siloam Hospitals Labuan Bajo, West Manggarai, Indonesia. Results: A 34-year-old multigravida with no antenatal care was diagnosed at 34 weeks’ gestation with placenta previa accreta and a singleton pregnancy. She had a history of one previous cesarean section and was admitted with antepartum hemorrhage. A planned referral to a specialized PAS center in Surabaya was interrupted by recurrent bleeding leading to hemorrhagic shock. An emergency cesarean section followed by hysterectomy was performed by a coordinated multidisciplinary team involving obstetrics-gynecology, surgery, urology, and anesthesiology–intensive care. The estimated blood loss was approximately 2000 mL. Both maternal and neonatal outcomes were favorable, with postoperative stabilization and no immediate complications. Histopathological confirmation was not performed due to limited facilities. Conclusion: Management of PAS in rural areas remains challenging because of limited access to early diagnosis, specialized referral centers, multidisciplinary teams, and blood bank services. This case highlights the importance of early recognition and multidisciplinary readiness to achieve favorable outcomes in low-resource settings. Keywords: antepartum hemorrhage, case report, multidisciplinary management, placenta accreta spectrum, rural settings
Co-Authors Firman Nugroho Maya Permatasari Suyata Michael Reiner Wangania Wim Pratama Wijaya