A Case of Placenta Percreta with Bladder Invasion

Abstract

          A 34 year-old G2P1 woman, 20 weeks gestation presented with massive gross hematuria and anuria due to blood clot obstruction. She had gross hematuria since 12 weeks gestation. Placenta percreta with bladder invasion was suspected by ultrasonography. The patient and her husband were counseling about her disease and plan of management. They decided to perform an operation. Hysterotomy, placental removal and subtotal hysterectomy with left salpingo-oophorectomy and bladder exploration were performed. Operative finding revealed placenta implanted at anterior lower uterine segment and invaded through posterior wall of bladder. Stop bleeding at bladder wall was done by electrocautery and sutured posterior bladder wall. She got well after operation without any complications. She was discharged on 7^th  day after operation and then followed up until serum β-hCG turn to normal level.