Successful Pregnancy with Placenta Accreta Spectrum and UterineAtony Following Conservative Ovarian Cancer Treatment: A CaseReport

Abstract

Background: Pregnancy following ovarian cancer treatment is rare but increasingly reported due to delayed childbearing and the predominance of ovarian germ cell tumours among women of reproductive age. Fertility preservation has therefore become a critical component of management in selected cases.
Case Presentation: We report the case of a 28-year-old Nigerian nulliparous woman (P0+0) previously diagnosed with a mixed germ cell ovarian tumour (embryonal carcinoma and yolk sac tumour). She underwent right ovarian cystectomy and left salpingo-oophorectomy, followed by five cycles of adjuvant chemotherapy. Remarkably, she later achieved a spontaneous conception. The pregnancy was complicated by placenta accreta spectrum disorder (placenta previa-increta), and uterine atony. She underwent an elective caesarean section at term, during which conservative surgical management of obstetric haemorrhage was successfully performed, resulting in a favourable maternal and fetal outcome.
Conclusion: Previous ovarian cancer treatment, including surgery and chemotherapy, may increase the risk of abnormal placentation, while its association with uterine atony remains unclear. This case demonstrates that successful pregnancy is possible after fertility-preserving treatment for ovarian germ cell tumours, though close monitoring for placental complications is essential. Further research and long-term follow-up are needed to clarify these risks.