Placenta Percreta with Bladder Wall Invasion: A Case Report
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2010-01-13
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Vajira Medical Journal
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Abstract Placenta Percreta with Bladder Wall Invasion: A Case Report Wisist Khorsuwandee BSc (Med), MD Department of Obstetrics and Gynecology, BMA Medical College and Vajira Hospital Placenta percreta was a very rare condition in the past. However, it is becoming more common in view of the increasing rates of cesarean section and advanced maternal age pregnancy. This condition could be life-threatening for both mother and infant, due to the consequences of disseminated intravascular coagulation (DIC) as well as its penetration into the adjacent organs such as intestine or urinary bladder. The treatment of placenta percreta can be done by either peripartum hysterectomy or medical therapy with conservation of the uterus and placenta. In this case report, a 43-year-old pregnant woman, gravida 3, was prenatally diagnosed as having placenta percreta with bladder wall invasion by an ultrasonographic study. She underwent a cesarean section with subtotal hysterectomy. Her infant was a normal male infant weighing 2,700 grams. The Apgar scores at 1 and 5 min were 10 and 10 respectively. Immediately post hysterectomy, the estimated blood loss was 2,000 ml. After that, there was a serious event of DIC causing further bleeding about 2,000 ml. This resulted in a necessarily blood and blood components replacement, so that such complication could be overcome. Postoperatively, both mother and infant were admitted for 11 days. At 1-month follow-up, they were in good condition. Vajira Med J 2007 ; 51 : 211 - 216
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Vajira Medical Journal; Vol. 51 No. 3 September - December 2007; 211 - 216