Nighat Sultana, Sobia Mohyuddin, Mohammad Riaz, Waqar Azim Niaz, Badar Murtaza.
Management of Placenta Percreta with Bladder Invasion.
J Pioneering Med Students Jan ;5(1):31-3.

Placenta percreta is an abnormal penetration of placental tissue through entire uterine wall and encroachment into the surrounding organs such as bladder and rectum. We present a case report of placenta percreta with bladder invasion to highlight the catastrophic nature of this clinical entity, which, if managed appropriately, is associated with a better outcome. A 29- year-old gravida 3, para 2 (both cesarean deliveries) was referred from a peripheral clinic to our tertiary care hospital with suspicion of major placenta previa accreta. She presented at 36 weeks gestation with complaints of continuous mild to moderate lower abdominal pain and hematuria for two days. Doppler ultrasound found central placenta previa extending up to bladder mucosa. Surgery was planned in collaboration with a multi-disciplinary team and was performed the following morning. A healthy baby girl was delivered by cesarean section followed by subtotal hysterectomy and bilateral internal iliac artery ligation leaving behind the whole placenta due to its morbid adherence to the bladder. Postoperatively methotrexate therapy was given. During follow-up, patient complained of urinary incontinence and underwent surgical correction in collaboration with a urologist. Patient had complete recovery at one year follow-up.

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