Журнал клинических случаев

Intraoperative Surgical Treatment of Undiagnosed Placenta Percreta

Abstract

Andras Malnar, Andrea Suranyi, Maria Jako and Gabor Nemeth

Background: To describe a case of a 38-year old pregnant woman with an intraoperative diagnosis of placenta percreta complicated by central placenta previa. The ultrasound scan did not show signs of any type of abnormal placental invasion, just central placenta previa was visualized.

Methods: At 36 weeks of gestation, she underwent an elective cesarean section combined with peripartum hysterectomy with bladder wall resection under general anesthesia because of antenatally undiagnosed placenta percreta.

Results: The therapy was provided by a multidisciplinary team, and the patient was in relatively good condition. Intraoperative blood loss was 2500 mL. A total of 10 units of red blood cells and 3 units of fresh frozen plasma were used. Anesthesia time was 2 h and 15 min. The postoperative course was adequate. A live, premature male baby (2420 g) was born 8 min after the beginning of the operation with Apgar scores 8 and 7 at 1 minute and 5 minutes.

Conclusion: We want to emphasize that, in spite of the absent typical symptoms and absent typical ultrasound signs of placenta percreta, we have to be cautious in the presence of risk factors. If we have a suspicion for adherent placenta, an MRI scan should be performed.