ABSTRACT
Placenta previa percreta with bladder invasion occurs rarely. However this disorder has become more common since the increased rate of cesarean deliveries. We present a 26 year old gravida 3, para 2-0-1-2 female with placenta previa, percreta and bladder invasion to stress out the importance of early recognition of this life threatening condition and to point out that the good outcome of this case was mainly due to the multidisciplinary approach chosen during the preoperative and post operative management. The Departments of Obstetrics and Gynecology, Radiology, Anesthesiology, Urology, Neonatology and Pathology were fully involved. A surgical management was chosen since it is the most common and more accepted treatment of placenta previa percreta with bladder invasion.
Subject(s)
Humans , Female , Adult , Urinary Bladder Diseases/surgery , Placenta Accreta/surgery , Placenta Previa/surgery , Apgar Score , Urinary Bladder/surgery , Cesarean Section , Urinary Bladder Diseases/diagnosis , Urinary Bladder Diseases , Hysterectomy , Infant, Newborn , Pregnancy , Pregnancy Outcome , Prenatal Care , Placenta Accreta/diagnosis , Placenta Accreta , Placenta Previa/diagnosis , Placenta Previa , Ultrasonography, Doppler, ColorABSTRACT
Acceleration of fetal maturation with intra-amniotic administration of thyroxine was employed in eight patients in whom preterm delivery was necessary because of malignant disease of the mother. Thyroxine (200 mcg to 500 mcg) was given at weekly intervals starting at the 27th to 32nd week of gestation until the L-S ratio exceeded 2.0. The fetuses were delivered between the 29.4 and 34.0 week. None of the newborns suffered from respiratory distress syndrome, and three newborns were cared for in the regular nursery. Thyroxine-induced acceleration of fetal maturation and pre-term delivery permits earlier initiation of antineoplastic and radiation therapy without exposing the fetus to the hazards of maternal therapy and those of prematurity.
