The doctors at Hai Phong International Obstetrics and Pediatrics Hospital have successfully performed a very complex surgery, ensuring safety for both mother and baby.

The patient, V.T.N, 32 years old, residing in Kien An, is pregnant for the third time, with the previous two pregnancies being cesarean sections. During this pregnancy, thanks to fully adhering to the prenatal check-up schedule as directed by the doctor (starting pregnancy management at Hai Phong International Obstetrics and Pediatrics Hospital from week 12 until delivery), by week 22, the pregnant woman was definitively diagnosed with central placenta previa. By week 25, the imaging diagnosis department doctors at Hai Phong International Obstetrics and Pediatrics Hospital had consulted and concluded: central placenta previa with a low-lying placenta. From this point, the patient was closely monitored and thoroughly advised and guided on the abnormal signs that required immediate hospitalization.

By week 35, the patient had undergone all necessary tests to prepare for the scheduled elective cesarean section in week 37 (if the pregnancy progresses smoothly). On September 1, 2025, the pregnant woman was admitted and monitored in the Prenatal Department at Hai Phong International Obstetrics and Pediatrics Hospital. Here, the patient received care, daily monitoring of maternal health and fetal heart rate, vaginal anti-inflammatory medication, and blood was preemptively arranged for timely transfusion during and after the surgery.

The patient was attended by Dr. Pham Thi Xuan Minh, MD, Head of the Obstetrics Department, along with Dr. Pham Van Do, MD, Deputy Head of the Department, and other doctors in the department who consulted and agreed on the decision for an elective cesarean section. The preparation work was arranged meticulously and carefully: the surgical team was led by Outstanding Physician, Dr. Tran Thi Viet Phuong, MD, Director of the Obstetrics Specialty, and Dr. Pham Van Do, MD, Deputy Head of the Obstetrics Department; the anesthesia and resuscitation team was directly managed by Dr. Nguyen Do Hung, MD, in coordination with experienced technicians from the department; the newborn reception team was led by Dr. Luong Thi Hong Hanh, MD, a neonatal resuscitation specialist from the Intensive Care Unit, along with two skilled midwives from the Delivery Department.

This is an extremely difficult surgery because the patient has had two previous cesarean sections, resulting in very complex adhesions. Right from the stage of separating the adhesions to expose the uterus was not easy at all. Once inside the uterus, the surgeon had to skillfully maneuver around the placenta, avoiding cutting through it – which could cause severe bleeding – to quickly extract the fetus. The entire process was a tense mental balancing act, requiring the surgeon to have composure, solid skills, and sharp experience. Because just one wrong move, or hesitation in an unreasonable decision, could lead to unpredictable consequences for both mother and baby, especially the risk of rapidly progressing acute blood loss.

With this case, thanks to thorough preparation in advance regarding personnel, blood, and related equipment, along with careful judgment and calculations, the surgery proceeded smoothly and systematically with each member of the team. Immediately after the fetus was extracted, the bleeding areas in the uterus were temporarily clamped to control the bleeding. Examination of the placenta confirmed that it was indeed a placenta accreta, penetrating through the uterine muscle at the site of a previous cesarean scar, which was very thin; in fact, many areas of the placenta had invaded the bladder wall. The surgeon immediately proceeded to ligate and cut two uterine arteries to minimize the acute bleeding that occurred afterward, and then sequentially performed the steps to cut the lower uterus until the entire area of the accreta was removed. Only a portion of the cervix remained, and both ovaries were preserved intact while successfully controlling the bleeding at the bladder wall due to the invasive placenta, which is a skilled technique in surgery that requires the surgeon to have experience and dexterity.