[Placenta percreta with invasion of the bladder, ureter and abdominal wall. Case report]

Roberto Carlos Ortiz-Villalobos1, Edith Esmeralda Luna-Covarrubias, Raymundo Felipe Serrano-Enríquez

  • 1Servicio de Obstetricia, Hospital General de Occidente, Secretaría de Salud de Jalisco. robertgine08@hotmail.com

Placental acretism is the abnormal adherence beyond the underlying of the uterine muscle. The penetration of the serous is known as placenta percreta. The following is a clinical study of a 28 year old woman, who had undergone 2 previous C-Sections, who had been admitted to the hospital previously with ultrasounds suggestive of placental acretism. The magnetic resonance show with severe infiltration of the myometrium in the anterior and lateral right, extending until the mesentery of the abdomen, top of the bladder and the proximal portion of the urethra as well as the soft tissue of the perinea. Cesarean section was performed at 35 weeks of gestation, once the complete protocol of the placenta previa, had been completed. The placentary tissue invaded the bladder, wide ligament along the entire right side and the posterior pelvis. A hysterectomy was performed in the fundic region, resulting in a live birth, and no complications for the patients. Later an obstetric hysterectomy was performed. It is important to note the exemplary work of the gynecologist, surgeon, urologist, anesthesiologist, neonatal specialist, hematologist and intensive care workers, working together for a common goal: avoiding the morbidity and mortality of the mother and child.

Related Concept Videos

Urinary Bladder01:23

Urinary Bladder

The urinary bladder is a hollow, muscular sac that temporarily stores urine before it is expelled from the body. It can hold approximately 600 mL of urine prior to micturition. The bladder is retroperitoneal and located behind the pubic symphysis in the pelvic floor.
In males, the bladder is situated in front of the rectum, while in females, it is positioned anterior to the vagina and uterus. The bladder floor contains an inverted triangular area called the trigone, defined by the two ureteric...
Ureters01:22

Ureters

The ureters are retroperitoneal tubes located on either side of the vertebral column. They are responsible for transporting urine from each kidney to the urinary bladder. These tubes have thick walls and are approximately 25-30 cm long. Their diameter is around 10 mm at the renal pelvis, gradually narrowing to 1 mm as the ureter obliquely enters the posterior bladder wall through the ureteric orifices. The shape of these orifices is slit-like, which helps to prevent urine backflow toward the...
Anatomy of the Genitourinary System II: Bladder and Urethra01:19

Anatomy of the Genitourinary System II: Bladder and Urethra

The lower urinary system consists of the urinary bladder and urethra, which are essential in storing and expelling urine from the body. Together with the internal and external sphincters, these structures work together to regulate urination effectively.Anatomy of the BladderThe urinary bladder is a muscular, stretchable organ behind the pubic bone and in front of the rectum. In females, the bladder is positioned anterior to the vagina and inferior to the uterus, while in males, it is located...
Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations01:26

Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations

Renal calculi, commonly termed kidney stones, are crystalline solid masses that form in the kidneys but can occur at any point within the urinary system, encompassing the kidneys, ureters, bladder, and urethra.The pathophysiology of renal stones involves several key factors: supersaturation of the urine with stone-forming constituents, changes in urine pH, a decrease in urine volume, and the presence of substances that promote or inhibit stone formation.Supersaturation of Urine: This is the...
Urinary Tract Infection II: Pathophysiology01:25

Urinary Tract Infection II: Pathophysiology

The pathophysiology of urinary tract infections (UTIs) encompasses several progressive stages, beginning with bacterial colonization and culminating in potential systemic complications if untreated. UTIs are primarily initiated by bacteria, such as Escherichia coli, which often originate from the gastrointestinal tract and migrate to the urinary system through the periurethral area. This migration can occur via several routes, including improper hygiene practices, sexual activity, or...
Acute Pyelonephritis I: Introduction01:27

Acute Pyelonephritis I: Introduction

Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such as Proteus,...