Successful management of a rare case of placenta percreta (original) (raw)
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A Case Report of Placenta Percreta
2021
There has been an increased incidence of placenta accreta in recent decades, which is associated with an increase in cesarean delivery. A woman aged 39 years GIVP1111 at 8 months of gestation was a breech location with antepartum bleeding et. causa placenta previa totalis suspected percreta bladder infiltration and hematuria. The last abdominal ultrasound showed no visible clot retention and mild right-sided hydronephrosis (possibly a physiological condition). Due to doubts regarding the suspicion of placental invasion of the bladder, an MRI examination of the abdomen was performed. A network is irregular in shape and can not be oriented either right or left, some of which have been split. Attached to the placenta. It was not clear that the cervix and bladder were visible, the total weight was 500 grams, the size was 15x13x5 cm. Based on both macroscopic and microscopic histopathological examinations, it can be concluded that the uterus, adnexa, surgery: placenta percreta, adenomyos...
Placenta percreta – a near miss
A type of morbidly adherent placenta in which chorionic villi completely invade the myometrium and may invade the serosa or adjoining organs, is known as Placenta Percreta. It is a very rare pregnancy problem and is associated with a high maternal and fetal morbidity and mortality. We present a case of placenta praevia percreta with massive intra-partum hemorrhage requiring an emergency cesarean hysterectomy. Keywords: Morbidly adherent Placenta, Placenta Percreta, Cesarean Hysterectomy
Placenta percreta - an audacious experience
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2016
Maternal and fetal morbidity and mortality from placenta accreta are considerable and are associated with high demands on health resources. There is abnormally firm attachment of placenta to the uterine wall with the absence of deciduas basalis and incomplete development of Nitabuch's layer. The reported incidence of placenta accreta has increased from approximately 0.8% in 1980s to 3 per 1000 in the last decade, occurring more frequently in future deliveries after caesarean section. Management of patients with a morbidly adherent placenta (placenta accreta, increta, or percreta) varies widely. Although the impact of a morbidly adherent placenta on pregnancy outcomes is well-described, no randomized trials have examined the management of pregnancies complicated by this disorder. As a result, recommendations for its management are based on case series and reports, personal experience, expert opinion, and good clinical judgement. We report a case of placenta percreta that was successfully managed by planned caesarean hysterectomy with prophylactic ligation of bilateral anterior division of internal iliac artery.
Placenta previa percreta following caesarean delivery: two case reports
Clinical and Experimental Obstetrics & Gynecology, 2022
Background: Placenta accreta spectrum (PAS) is a clinical term used to describe the abnormal trophoblast invasion into the myometrium of the uterine wall and may enter into the serosa or even into adjacent organs. It is associated with severe obstetric haemorrhage and often requires emergency hysterectomy, which is one of the foremost causes of maternal morbidity and mortality. The vast of these conditions are seen in women with a history of previous caesarean section and placenta previa. Cases: In this study we present two cases of a rare type of PAS, placenta percreta, in women with a history of previous caesarean section (CS). Both instances were diagnosed prenatally, using the method of ultrasound and magnetic resonance imaging. They were scheduled for deliveries by CS, and both were hysterectomized. These diagnoses were confirmed in histopathological findings. Conclusion: Considering sparse published data and absence of well conducted studies, optimal management is still undefined. Caesarean hysterectomy is still the gold standard treatment for placenta accreta spectrum proposed by many societies as an absolute and final treatment.
Cureus
In rare situations, pregnant women may experience life-threatening bleeding due to the placenta's aberrant invasion of the bladder. A 28-year-old pregnant female with two previous cesarean deliveries presented with the chief complaint of abdominal pain at the earlier scar site. Ultrasound imaging was suggestive of placenta percreta with bladder invasion. The patient underwent elective cesarean section with a uterine-preservation strategy. A healthy male baby was delivered by classical cesarean section, and bilateral uterine artery ligation was done. The patient developed severe postoperative hemorrhage, for which she was re-explored, and the urology team was called for intraoperative assistance. The area of placental invasion into the bladder was resected entirely with bladder reconstruction. Placenta percreta is a life-threatening condition that can involve adjacent uterine structures. Successful management involves a multidisciplinary strategy involving experienced obstetricians, urologists, anesthesiologists, blood bank teams, and neonatologists.
Management of placenta percreta – case report and clinic experience
Romanian Journal of Medical Practice
The incidence of placenta percreta is currently increasing. The treatment strategies are not clearly defined as there are a lot of inconsistencies in the literature regarding severity criteria. This pathology has a high risk for massive hemorrhage, therefore it is very challenging to agree on a standardized management. The therapeutic approaches include expectant management with placenta left in situ, conservative management and radical treatment. Cesarean hysterectomy currently represents the approach of choice for this condition, ideally performed by a multidisciplinary team. Conservative alternatives have been proposed to reduce maternal morbidity and maintain future fertility. The expectant management has benefits on reducing uterine perfusion and blood loss, useful in case of bladder or parametrial invasion. Potential late complications of placenta percreta left in situ often require further emergency surgery. Delayed hysterectomy has the aim to overcome these difficulties, but...
Conservative management of placenta percreta: A case report
Morbidly adherent placenta is a rare complication of pregnancy associated with high maternal morbidity. It may cause massive haemorrhage thereby requiring emergency hysterectomy. We present a case of placenta percreta which was manged succesfully by conservative management.
Placenta previa percreta: a case report on diagnosis and management
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
A 37-year-old female patient, G2P1L1, previous caesarean section, presented at 27 weeks of gestation, with the chief complaint of spotting per-vaginum, not associated with pain in the abdomen. The ultrasound performed was s/o placenta previa with placenta increta. She presented with similar complaints on and off during the second trimester and was treated conservatively. Follow up scans revealed placenta percreta and the pregnancy was electively terminated at 33 weeks. A multidisciplinary team, consisting of a urosurgeon, a gynaecologist and an interventional radiologist were present during the procedure. The patient recovered fully.