Placenta Percreta Invading the Urinary Bladder

Abstract

The placenta, normally confined to the decidual lining of the uterine cavity, can in some circumstances invade the muscular wall of the uterus, a condition known as placenta accreta. Less common is placenta increta, in which placental cotyledons become intertwined with the muscular stroma of the uterus. Placenta percreta, in which the trophoblastic tissues penetrate the serosa of the uterus and may extend directly to adjacent structures, is even more rare and is potentially life-threatening. There have been only 10 reports of direct invasion of placenta percreta into the urinary bladder. We review these cases and report 3 recent patients, one of whom was diagnosed pre-operatively by ultrasonography.

The Aftermath of Scarred Uterus: Placenta praevia accreta of Different Grades

“…Placenta percreta involving the bladder has also been diagnosed antenatally by ultra sound [17], Magnetic resonance imaging might be of benefit in establishing an antena tal diagnosis of these cases [32]. Cystoscopydirected biopsy was reported by Taefi et al [31 ] to establish antenatal diagnosis, however, his method evoked severe bleeding.…”

Successful management of a rare case of placenta percreta

“…3 Women who had a previous caesarean delivery, other previous uterine surgery, an IVF pregnancy and placenta praevia diagnosed antepartum had raised odds of having placenta accreta/increta/percreta. 6 Obs USG can be used to diagonse placenta accreta antenatally, which allows for scheduled delivery at multidisciplinary center for excellence.…”

“…Controversies exist regarding optimal management, including optimal timing of delivery, surgical approach, and use of adjunctive measures. 3 Patients with placental adhesive disorders frequently require urological Intervention to prevent or repair injury to the urinary tract.…”

“…3 Placenta accreta is abnormal adherence of the placenta to the uterine wall and the most common cause for emergency peripartum hysterectomy. 1 The incidence of placenta accreta has increased recently with increasing caesarean delivery rate.…”

Placenta Percreta: A Rare Cause of Uterine Rupture during the Second Trimester of Pregnancy

“…Because of the silent nature of placental invasion, the patient often presents initially with shock or signs of intra-abdominal hemorrhage. However, patients have also been reported to have initial hematuria or hematochezia caused by placental penetration of the bladder or bowel mucosa [3]. Placenta percreta commonly presents in the third, and rarely, in the second trimester of pregnancy.…”