Placenta percreta with bladder invasion: a rare cause of hematuria in pregnancy

Abstract

Placenta percreta is a disorder of placental implantation that significantly increases maternal and fetal morbidity and is characterized by plasental villi invasion to the myometrium, serosa and, rarely, the bladder, penetrating through the decidual layer. Here, we report a 33-year-old patient in the 24th week of gestation, diagnosed with placenta percreta with bladder invasion, and we present a brief review of the literature. ÖZETPlasenta perkreta, plasenta villilerinin desidual tabakayı delerek miyometriumu, serozayı ve nadiren mesaneyi invaze etmesiyle karekterize, maternal ve fetal morbiditeyi belirgin olarak arttıran plasental implantasyon bozukluğudur. Bu olguda, plasenta perkreta ve mesane invazyonu saptanan 33 yaşında, 24 haftalık gebe bir hasta rapor edilmiş ve literatür kısaca gözden geçirilmiştir.

Placenta percreta in pregnant woman with massive hematuria: a case report

“…Hysterectomy and partial cystectomy were performed to the patient due to PP with missed diagnosis, and hypovolemic shock (and massive blood transfusion need accordingly) and convulsion attacks were observed in the patient during postoperative period. [10] The possibility of complications such as massive blood transfusion, infection, perinatal death, maternal death, urethral ligation or fistula formation and spontaneous uterine rupture is quite high in placenta percreta cases. [10,11] Therefore, PP monitoring should be carried out with a multidisciplinary approach by a team consisting of experts from obstetrics, anesthesiology and intense care, radiology, urology and hematology clinics.…”

“…[10] The possibility of complications such as massive blood transfusion, infection, perinatal death, maternal death, urethral ligation or fistula formation and spontaneous uterine rupture is quite high in placenta percreta cases. [10,11] Therefore, PP monitoring should be carried out with a multidisciplinary approach by a team consisting of experts from obstetrics, anesthesiology and intense care, radiology, urology and hematology clinics. [4,12] In our case, establishing PP diagnosis before operation and acting together with the clinics of obstetrics, urology, anesthesia-intense care and hematology were effective to prevent hysterectomy and other major complications.…”