scholarly journals A Case Report of Placenta Percreta

2021 ◽  
Vol 5 (4) ◽  
pp. 139-145
Author(s):  
Widiana Ferriastuti ◽  
Dwi P. R. Tampubolon ◽  
Qonita Qonita
Keyword(s):  
Case Report ◽  
Cesarean Delivery ◽  
Physiological Condition ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Abdominal Ultrasound ◽  
Placenta Percreta ◽  
Total Weight ◽  
Clot Retention ◽  
Placental Invasion

There has been an increased incidence of placenta accreta in recent decades, which is associated with an increase in cesarean delivery. A woman aged 39 years GIVP1111 at 8 months of gestation was a breech location with antepartum bleeding et. causa placenta previa totalis suspected percreta bladder infiltration and hematuria. The last abdominal ultrasound showed no visible clot retention and mild right-sided hydronephrosis (possibly a physiological condition). Due to doubts regarding the suspicion of placental invasion of the bladder, an MRI examination of the abdomen was performed. A network was irregular in shape and can not be oriented either right or left, some of which have been split. Attached to the placenta. It was not clear that the cervix and bladder were visible, the total weight was 500 grams, the size was 15x13x5 cm. Based on both macroscopic and microscopic histopathological examinations, it could be concluded that the uterus, adnexa, surgery: placenta percreta, adenomyosis uteri. Keywords: placenta percreta; uterus; antepartum bleeding

Prior Cesarean Delivery Healthcare Facilities Variations in Pregnancy Outcomes of Placenta Accreta Spectrum with Placenta Previa: A retrospective study from a tertiary transferal center (Preprint)

2021 ◽  
Author(s):  
Xuan Gao ◽  
Shaoshuai Wang ◽  
Lijie Wei ◽  
Peng Gao ◽  
Jiaqi Li ◽  
...  
Keyword(s):  
Cesarean Delivery ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Placenta Percreta ◽  
County Level ◽  
Healthcare Facilities ◽  
Placenta Accreta Spectrum ◽  
Province Level ◽  
Rural Township ◽  
Previous Cesarean

BACKGROUND The prevalence of Placenta Accreta Spectrum(PAS) is increasing rapidly linked with the cesarean rate increase worldwide, creating a threatening condition from severe postpartum hemorrhage to various maternal morbidities. The socio-economic imbalance, geographical, qualification, and specialty variations of the previous cesarean delivery healthcare facilities resulted in assessment and management difficulties. OBJECTIVE To assess variations of prior cesarean delivery healthcare facilities on pregnancy outcomes on current PAS with Placenta Previa. METHODS This retrospective study was conducted in a tertiary referral center from Nov.2015 to Nov.2020 in central China. Healthcare facilities were classified by geographical, hospital grading, ownership, and specialty variations. The primary outcome was postpartum hemorrhage(PPH), secondary outcomes included Placenta Percreta and maternal-fetal morbidities. RESULTS In total, 252 patients were enrolled, 58(23%) patients had Placenta Accreta, 131(52%) had Placenta Increta and 63(25%) had Placenta Percreta. The overall incidence of PPH was 47.2%(119 out of 252). As the administrative geographical level becoming smaller and more distant, PPH incidence climbed up: province-level(10, 32.3%), prefecture-level(65, 48.5%), county-level(30, 42.3%), and rural township(14, 82.5%), P for trend= 0.019. The odds of PPH in rural township clinics was 5.84(P=0.03, 95%CI 1.18~28.77) compared to the province-level hospitals. Similarly, when hospital grades declined, PPH incidence raised: tertiary(26, 39.4%), secondary(28, 43.8%), primary(14, 38.9%) and unclassified(51, 59.3%), P for trend= 0.047. Unclassified hospitals had 2.16(P= 0.046, 95%CI 1.02~4.61) times odds of PPH compared to tertiary medical centers. PPH showed no statistical significance based on ownership or specialty variations. Also, Placenta Percreta increased when geographical location shifted from urban to rural: three (9.7%) from province-level, 34(25.6%) from prefecture-level, 18(25.4%) from county-level and eight(47.1%) from rural township clinics, P= 0.04, P for trend =0.018. Patients with previous rural township clinics cesarean delivery had a 7.49 times risk((P=0.011, 95%CI 1.59~35.19) of developing Placenta Percreta compared with province-level hospitals. CONCLUSIONS Healthcare facilities variations of the previous cesarean delivery have upcoming impacts on subsequent pregnancy. The tendency of experiencing adverse maternal outcomes is more significant with prior cesarean in the rural township clinics and unclassified hospitals. The findings call for physicians’ alertness, persistent efforts in urban-rural disparity reduction, and measures to achieve equitable management.

scholarly journals Case Report: Anaesthetic Management of Placenta Percreta

2022 ◽  
Vol 9 (1) ◽  
pp. 39-44
Author(s):  
Subir Kumar Ghosh ◽  
Babita Ramdev ◽  
Noorjit Sidhu
Keyword(s):  
Case Report ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Bladder Wall ◽  
Hemodynamic Instability ◽  
Placenta Percreta ◽  
Elective Cesarean Section ◽  
Mortality And Morbidity ◽  
Risk Pregnancy ◽  
Perioperative Bleeding

Background: The placenta is a complicated organ and is partially understood. It is the essential part for physiological changes leading to a successful pregnancy. Placenta percreta is the most severe and least common form of placenta accreta in which villi penetrate the entire myometrial thickness and reach or traverse the serosa to encroach adjacent organs. Patients with placenta percreta are at a greater risk of life-threatening perioperative bleeding as well as massive and deadly thromboembolic events. Case report: Our patient was a 34-year-old gravida 5female who underwent elective cesarean section at 37 weeks of gestation with a diagnosis of placenta accreta or percreta. Intraoperative findings showed placenta percreta with bladder wall involvement. Hence, hysterectomy was done. Anticipated intraoperative haemorrhage and hemodynamic instability were managed properly. Discussion: Placenta percreta is the most serious among abnormal placentation, sometimes leading to catastrophic blood loss and very high maternal mortality and morbidity up to 10%. The most important risk factor in placenta percreta is placenta previa (low lying placenta) after cesarean delivery. Our patient met all these risk factors. Prenatal diagnosis of an invasive placenta is paramount for reducing maternal morbidity and mortality by implementing a multidisciplinary approach. Keywords: haemorrhage, placenta percreta, hysterectomy, high-risk pregnancy.

Sonographic Detection of Placenta Percreta With Associated Placenta Previa and Succenturiate Lobe

2021 ◽  
Vol 37 (2) ◽  
pp. 194-199
Author(s):  
Melissa Detweiler ◽  
Emily Downs
Keyword(s):  
Placenta Accreta ◽  
Imaging Modality ◽  
Placenta Previa ◽  
Placenta Percreta ◽  
Clinical Factors ◽  
Placenta Accreta Spectrum ◽  
Placental Invasion

Placenta percreta is the most complicated degree of the placenta accreta spectrum (PAS). It involves placental invasion through the uterine myometrium and into, or beyond, the uterine serosa, which can ultimately lead to severe maternal hemorrhage. Placenta previa is often associated with PAS and can be a significant indicator, along with other clinical factors. Sonography has historically been a highly accurate and safe imaging modality to assess the PAS. This specific case examines a patient with a pathologically proven percreta with an associated previa and succenturiate placental lobe.

scholarly journals Burkitt’s lymphoma with placental invasion diagnosed at cesarean delivery: a case report

2018 ◽  
Vol 12 (1) ◽  
Author(s):  
Cielo Gnecco ◽  
S.J. Carlan ◽  
Jeannie McWhorter ◽  
Li Ge ◽  
Daniel Sanchez ◽  
...  
Keyword(s):  
Case Report ◽  
Cesarean Delivery ◽  
Burkitt’S Lymphoma ◽  
Burkitt's Lymphoma ◽  
Placental Invasion

scholarly journals Management of placenta percreta. A case report

2020 ◽  
pp. 01-04
Author(s):  
DIOUF A ◽  
Thiam O ◽  
Ndour K ◽  
Gueye M ◽  
Ndiaye MD ◽  
...  
Keyword(s):  
Placenta Accreta ◽  
Placenta Previa ◽  
Multiple Organ ◽  
Placenta Percreta ◽  
High Parity ◽  
Surgical Wounds ◽  
History Of ◽  
Uterine Curettage ◽  
High Risk Situation ◽  
Previous Cesarean

The placenta accreta designates an abnormality of the placental insertion characterized, on the anatomopathological level, by an absence of deciduous deciduous between the placenta and the myometrium. This insertion anomaly may interest all or only part of the placenta. We distinguish within this terminology the terms of - placenta accreta when the placenta is simply attached to the Myometrium. - placenta increta when the placenta invades the myometrium. - placenta percreta when the placenta enters the serosa uterine, or even the neighboring organs (bladder, peritoneum, etc.) [1]. Placentas accretas are a high-risk situation for severe postpartum hemorrhage and its inherent complications such as disseminated intravascular coagulation, hemostasis hysterectomy, surgical wounds to the ureters, bladder, multiple organ failure, or even maternal death, particularly in the case of placenta percreta [2,3]. Risk factors for placenta percreta include a history of cesarean, uterine curettage or manual removal of placenta, presence of placenta previa, endometriosis, high parity and advanced maternal age [4]. We report the case of a 30-year-old woman, IIGIIP, who had a previous cesarean section during her first pregnancy and who had a placenta percreta and who underwent hysterectomy without cystectomy and without ligation of the hypogastric arteries.

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