Successful conservative management in placenta previa percreta involving urinary bladder

Abstract

Background: Placenta Previa Percreta is a potentially life-threatening obstetric condition that requires a multidisciplinary approach to management. The incidence of placenta accrete/percreta has been increased now and seems to parallel the increasing caesarean section (CS) rate. Case Presentation: This is a case of morbidly adherent placenta successfully managed conservatively. The patient was G 3 P 2 L 2 with previous 2 lower segment caesarean sections (CS), antenatally diagnosed to be anterior placenta previa with placenta percreta. Elective classical CS followed by post op bilateral uterine artery embolization was done for this case. She required only 2 blood transfusions peri-operatively. The baby was fine. She required re-embolization after 5 weeks for hematuria due to bladder invasion of placenta percreta. Serum beta hCG value became normal after 18-20 weeks. She is doing well with normal menstrual cycle 1 year after classical caesarean section. Conclusion: Conservative management of placenta previa percreta, especially when involving bladder even if fertility preservation is not the concern, should be preferred over caesarean hysterectomy if facilities are available.