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Article
October 13, 1978

Placenta Previa Percreta With Bladder Invasion

Author Affiliations

From the Department of Obstetrics and Gynecology, Miami Valley Hospital, Dayton, Ohio.

JAMA. 1978;240(16):1749. doi:10.1001/jama.1978.03290160067028
Abstract

PLACENTA percreta is a rare but potentially catastrophic obstetric condition, with a high incidence of fetal death and maternal mortality and morbidity. First reported in 1900, only 37 cases had been documented by 1970. Placenta percreta with bladder invasion is even more uncommon, with only four cases previously described.1-4

We present a case of placenta previa percreta with bladder invasion resulting in massive hemorrhage and prolonged shock.

Report of a Case  A 31-year-old woman, gravida 4, para 3, registered for prenatal care at ten weeks of pregnancy. She had undergone three previous cesarean sections without difficulty. She weighed 125 kg and was mildly hypertensive. At 12 weeks of pregnancy, she bled about 100 ml of bright red blood during one day; otherwise, her prenatal course was uneventful.At term, routine repeated cesarean section was begun under spinal anesthesia. The anterior aspect of the uterus was covered by huge varicosities

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