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Placenta percreta invading the urinary bladder
Noriyuki Takai1, Masako Eto, Fuminori Sato
1Department of Obstetrics and Gynecology, Oita University Faculty of Medicine, Hasama-machi, Oita 879-5593, Japan. takai@med.oita-u.ac.jp
Archives of Gynecology and Obstetrics
|March 26, 2005
Summary
Placenta percreta invading the bladder is a rare obstetric emergency. Cesarean hysterectomy with partial bladder resection managed severe hemorrhage in this case.
Area of Science:
- Obstetrics and Gynecology
- Surgical Oncology
- Urology
Background:
- Placenta percreta is a rare obstetric complication characterized by abnormal placental implantation.
- It can lead to life-threatening hemorrhage due to placental invasion into the uterine wall and adjacent organs.
- Urinary bladder invasion by placenta percreta presents unique surgical challenges.
Observation:
- A case of placenta percreta with extensive urinary bladder invasion is presented.
- The patient underwent a complex surgical procedure involving cesarean hysterectomy and partial bladder resection.
- Significant blood loss (11,130 ml) and transfusion of 59 units of blood products were required.
Findings:
- Surgical management involving cesarean hysterectomy and partial bladder resection can be effective for placenta percreta invading the bladder.
- This condition necessitates a multidisciplinary approach involving obstetricians, gynecologists, and urologists.
- Aggressive fluid resuscitation and blood product transfusion are critical for managing intraoperative hemorrhage.
Implications:
- Awareness of placenta percreta, particularly with bladder invasion, is crucial for obstetricians and urologists.
- Early recognition and multidisciplinary surgical planning can improve outcomes in these rare cases.
- This case highlights the importance of preparedness for managing massive obstetric hemorrhage.