Placenta Percreta with Bladder Invasion: Case Report

Abstract

Background: Placenta previa with bladder invasion is an uncommon and serious pathology, involving the maternal prognosis. However, as the rate of cesareans has increased, the disease has become more common. Case presentation: We present the case of placenta previa percreta in 34 weeks of amenorrhea, gravida 2 para 1, with a history of a single caesarean section 5 years prior. Initially admitted for threat of premature delivery, we found a totally covering placenta previa with accretization sign and suspicion of bladder invasion. Abdomino pelvic MRI confirmed the diagnosis of placenta previa percreta. During monitoring, the patient presented an acute fetal distress requiring an emergency fetal extraction. She underwent a caesarean section for fetal rescue followed by a total hysterectomy requiring the removing of the anterior part of the bladder. Conclusion: With a rising rate of cesarean sections, the risk of placenta accreta spectrum is increasing as well. Obstetricians and clinicians should be vigilant in prenatal diagnosis, especially if the risk factors are present. Multidisciplinary approach for preoperative, intraoperative and postoperative management can significantly improve maternal and fetal prognosis.