Case 41-year-old women, P3, all NVD, was complaining of chronic pelvic pain and menorrhagia which caused her anaemia. She had hysteroscopy and Mirena" insertion with no benefit. Two years later she removed Mirena" and had NovaSure" endometrial ablation. Two years later, she accidently got pregnant. She tried medical management with no response at 8 + 1/40. She was counselled about surgical management with risk of bleeding and
hysterectomy and she demanded hysterectomy to stop menses and terminate the pregnancy. Total abdominal hysterectomy was done and uterus sent to pathology. Pathology showed evidence of wide spread invasion of placental trophoblast and villi to superficial layer of myometrium. Appearance are fully keeping with placenta accreta at 8 weeks of gestational age. No evidence of malignancy was seen. Postoperative recovery was unremarkable.
Conclusion Reinforce importance of prescribing contraception after endometrial ablation and highlight risks associated if pregnancy occurs.