A case of placenta previa percreta with bladder invasion / 대한산부인과학회잡지

ABSTRACT

Placenta percreta with bladder invasion is an extremely rare complication causing life-threatening hemorrhage, up to 17 liters.1 Most reported cases have been diagnosed after 30 weeks of pregnancy and few have presented before 20 weeks.2 Only 20 cases of placenta percreta with invasion of the bladder have been reported during last decade. In this condition, chorionic villi attach directly to the myometrium without intervening decidua. The exact etiology of impaired decidualization is unknown; however, a previous endometrial insult, such as previous cesarian section or endometrial curettage may be a contributing factor. To avoid massive bleeding, uterine body incision, hypogastric artery ligation before hysterectomy and uterine cervical removal have been attempted.1 Chorionic villi may attach to the myometrium (accreta), invade the myometrium(increta), or in its severe form (percreta) the trophoblastic tissue penetrates the whole myometrium and invades adjacent structures. We experienced a case of placenta previa percreta with bladder invasion and review the literatures.