Suggested approach for management of placenta percreta invading the urinary bladder

Management of placenta percreta invading the urinary bladder usually requires radical surgery, which may include partial or total resection of the bladder.

A multigravida presented with placenta previa percreta invading the urinary bladder. Preoperatively, prophylactic occlusive balloon catheters were placed in the internal iliac arteries and were inflated after cesarean delivery of a healthy newborn. Subtotal hysterectomy with removal of a large part of the placental volume was then performed. Part of the placenta that was adherent to the bladder was left in situ. This way we were able to avoid severe blood loss and preserve the bladder intact. The woman was discharged healthy, on day 9 postoperatively.

We suggest an alternative approach for managing placenta percreta invading the bladder, which may reduce blood loss and preserve an intact bladder.