Postmenopausal Pregnancy Via Oocyte Donor and Suspected Focal Placenta Accreta: A Case Report

TL;DR

A 59-year-old postmenopausal woman had a pregnancy using donor eggs and experienced a suspected placenta accreta complication, highlighting unique challenges in such pregnancies.

Contribution

This case report highlights placental pathology in postmenopausal pregnancies and identifies potential mechanisms affecting placental health.

Findings

Histopathological analysis showed abnormal placental architecture with villi invasion.

Congested blood vessels, inflammatory cells, and increased collagen suggest placental pathology.

The case underscores the need for further research into placental health in postmenopausal pregnancies.

Abstract

Advances in assisted reproductive technologies have enabled postmenopausal women to achieve pregnancy beyond their reproductive lifespan. Although rare, these pregnancies are challenging and require a multidisciplinary approach due to the higher prevalence of medical comorbidities in this population. The placenta accreta spectrum is characterized by an abnormal invasion of chorionic villi into the myometrium. Risk factors associated with the placenta accreta spectrum include prior uterine surgeries, advanced maternal age, multiparity, in vitro fertilization, and placenta previa. We present a case of a 59-year-old postmenopausal woman with chronic hypertension, stage II chronic kidney injury, and superimposed pre-eclampsia who underwent cesarean delivery complicated by suspected focal placenta accreta. Histopathological examination revealed significant deviations from normative placental architecture, emphasizing the invasion of the villi. Further, congested blood vessels and the presence of inflammatory cells, along with heightened collagen deposition, suggest an underlying pathological process affecting placental health. These findings underscore a perturbation of placental homeostasis, emphasizing the necessity for further investigation into the mechanisms contributing to placental pathology in postmenopausal pregnancies.

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