Medical and surgical treatment of placenta percreta to optimize bladder preservation.

Journal Article

BACKGROUND: Placenta percreta is associated with significant morbidity and mortality. Interventions are dictated by hemodynamic stability, desire to retain future fertility, and efforts to reduce surgical morbidity at time of delivery. CASES: Two cases of antenatally diagnosed placenta percreta with bladder invasion are presented. Conservative management was used, including endovascular interventions, leaving the placenta in situ, methotrexate, and delayed hysterectomy. Postoperative outcomes were acceptable, with no significant hemorrhagic complications or need for extensive bladder reconstruction. CONCLUSION: Antenatal diagnosis of placenta percreta with bladder invasion is essential in the multidisciplinary management of this potentially catastrophic condition. A comprehensive approach including delayed hysterectomy after medical management resulted in an excellent clinical outcome.

Full Text

Duke Authors

Cited Authors

  • Lee, PS; Bakelaar, R; Fitpatrick, CB; Ellestad, SC; Havrilesky, LJ; Alvarez Secord, A

Published Date

  • August 2008

Published In

Volume / Issue

  • 112 / 2 Pt 2

Start / End Page

  • 421 - 424

PubMed ID

  • 18669749

International Standard Serial Number (ISSN)

  • 0029-7844

Digital Object Identifier (DOI)

  • 10.1097/AOG.0b013e31817e7966

Language

  • eng

Conference Location

  • United States