Difficulty of the surgical management of a case with placenta percreta invading towards parametrium

A 37‐year‐old woman was admitted due to vaginal bleeding at 25 weeks of gestation to our gynecology unit. Placenta percreta, which stems from posterior wall of the uterus, forming a mass in Douglas cavity and invading towards right parametrium was clinically diagnosed by exploration. Bilateral inter...

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Bibliographic Details
Published in:The journal of obstetrics and gynaecology research 2008-06, Vol.34 (3), p.402-404
Main Authors: Borekci, Bunyamin, Ingec, Metin, Kumtepe, Yakup, Gundogdu, Cemal, Kadanali, Sedat
Format: Article
Language:English
Subjects:
Adult
Blood Loss, Surgical
Blood Transfusion
Chorionic Villi - pathology
Female
Gestational Age
Humans
Myometrium - pathology
parametrial invasion
Placenta Accreta - diagnosis
Placenta Accreta - pathology
Placenta Accreta - surgery
placenta percreta
Pregnancy
surgical management
Uterine Hemorrhage
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Summary:A 37‐year‐old woman was admitted due to vaginal bleeding at 25 weeks of gestation to our gynecology unit. Placenta percreta, which stems from posterior wall of the uterus, forming a mass in Douglas cavity and invading towards right parametrium was clinically diagnosed by exploration. Bilateral internal iliac artery ligation and supracervical hysterectomy could not prevent bleeding. A right radical parametrectomy was necessary to remove invaded parametrium and to control bleeding. The placenta percreta invading parametrium may need an extended hysterectomy procedure. Excess bleeding may be prevented by leaving the placenta in situ during surgery if the placenta percreta is diagnosed before termination of pregnancy, A classical incision may help leaving placenta is situ during operation.
ISSN:1341-8076
1447-0756
DOI:10.1111/j.1447-0756.2008.00780.x