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[Placenta percreta with bladder invasion. Case report].

Luis Guillermo Torres Gómez1, Emigdio Torres Farías, Rosa María Rodríguez Sandoval

  • 1Departamento de embarazo de alto riesgo, Unidad Médica de Alta Especialidad, Hospital de Gineco-Obstetricia, CMNO, IMSS. memotg1@cybercable.net.mx

Ginecologia Y Obstetricia De Mexico
|February 26, 2008
PubMed
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A rare case of placenta percreta invading the urinary bladder in a woman with two prior cesarean sections required a cesarean hysterectomy and bladder repair for preterm premature rupture of membranes.

Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Surgical Gynecology

Background:

  • Placenta percreta, a rare placental abnormality, occurs when chorionic villi invade the myometrium and can extend into adjacent organs.
  • Previous cesarean sections are a significant risk factor for developing placenta accreta spectrum disorders.
  • Early diagnosis and multidisciplinary management are crucial for improving outcomes in placenta percreta cases.

Observation:

  • A 30-year-old woman with a history of two cesarean sections presented at 18 weeks gestation.
  • Pelvic ultrasonography and color Doppler imaging revealed placenta percreta with urinary bladder invasion.
  • The patient experienced preterm premature rupture of membranes at 27 weeks gestation.

Findings:

  • A cesarean section was performed at 27 weeks gestation due to preterm premature rupture of membranes.

Related Experiment Videos

  • Placental tissue was found to be firmly adherent to the anterior bladder surface.
  • A cesarean hysterectomy was performed, preceded by bilateral anterior internal iliac artery ligation.
  • The urinary bladder was successfully repaired and a suprapubic catheter was placed.

    • Implications:

    • This case highlights the critical importance of advanced imaging in diagnosing placenta percreta, especially in high-risk pregnancies.
    • Surgical management involving hysterectomy and arterial ligation demonstrates a viable approach for managing bladder invasion.
    • Successful bladder repair and catheterization underscore the possibility of preserving bladder function in complex cases.
    • Multidisciplinary collaboration between obstetrics, gynecology, urology, and radiology is essential for optimal patient care.