Enormous placenta percreta bleeding in a twin pregnancy: a case report

Hemorrhage is the most important cause of death in pregnant mothers around the world. One of the causes of severe and fatal bleeding is placenta percreta, which is not easily controlled despite hysterectomy, due to placental invasion of the pelvic organs, and can cause coagulation disorders and maternal death. In placenta percreta cases, it is impossible to establish hemostasis with the usual methods.

The patient was a 34-year-old Gravida 3 Para 2 Living 2 Afghan woman. She had twins at 35 weeks of pregnancy. She was hospitalized due to placenta percreta and urinary retention. The patient was a candidate for emergency cesarean hysterectomy because of the nonreassuing non-stress test of the fetuses. When the hysterectomy was performed, despite the total hysterectomy, severe uncontrollable bleeding continued from the pelvic floor and vaginal cuff. Bilateral hypogastric vessels were ligated, but the bleeding continued, and the hemodynamic status of the patient was deteriorating. Finally, the surgical team decided to pack the pelvis, which saved the patient's life.

Packing the vagina and pelvis at the same time in the enormous bleeding in placenta percreta cases is a straightforward and low-cost solution that can save the patient's life.