Successful Management of Rare Case of Placenta Percreta upto Anterior Abdominal Wall
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Successful Management of Rare Case of Placenta Percreta upto Anterior Abdominal Wall Arun Harishchandra Nayak1 · Archana Anil Bhosale1 · Madhuri Alap Mehendale1 · Shraddha Ashok Mevada1 · Bharti Mandal1 · Hemantkumar Pandharinath Chaudhari1 Received: 21 March 2020 / Accepted: 29 May 2020 © Federation of Obstetric & Gynecological Societies of India 2020
We report a case of 23-year old female, G2P1NND1 with previous 1 LSCS, 30.2 weeks presented with gross blackish discolouration of skin in lower abdomen and pain in abdomen. Clinical diagnosis was placenta percreta reaching upto anterior abdominal wall (Fig. 1). Ultrasonography showed hyperechoic lesion with fat content in left paramedian infraumbilical region. MRI confirmed focal herniation of the placenta at the site of LSCS scar reaching upto anterior abdominal wall (Fig. 2). Intraarterial balloon inflation of uterine arteries was done followed by Laparotomy. Intraoperatively, placental tissue was seen adherent to anterior abdominal wall and dome of the bladder (Fig. 3). Baby was delivered by Classical Caesarean Section and immediately afterwards, partial separation of placental tissue was noted (Fig. 4).Within a span of 10 min, almost 3 L of blood loss occurred and hence Total Obstetric Hysterectomy was performed and both the ovaries were preserved. Patient was transfused with 5 PRC and 5 FFP. Post-operative period was uneventful and patient was discharged after 15 days. On follow-up visit, there was significant reduction of blackish discolouration of skin without any other complications (Fig. 5).
Acknowledgements Department of Obstetrics and Gynaecology, Lokmanya Tilak Medical College, Mumbai, India. Funding None.
Compliance with Ethical Standards Conflict of Interest Nil. Informed Consent Informed consent was taken in local language.
* Shraddha Ashok Mevada [email protected] 1
Lokmanya Tilak Medical College, Mumbai, India
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Fig. 1 Shows 30 weeks gestation with gross blackish discolouration of skin in placenta percreta reaching upto anterior abdominal wall
A. H. Nayak et al.
Fig. 3 Shows placenta tissue adherent to lower anterior abdominal wall in infraumbilical region
Fig. 4 Shows placental tissue adherent to lower uterine segment Fig. 2 Shows MRI report shows herniation of the placenta tissue at the site of LSCS scar on reaching upto anterior abdominal wall
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Successful Management of Rare Case of Placenta Percreta upto Anterior Abdominal Wall
About the Author
Fig. 5 Photograph of abdomen during follow up visit after 2 weeks
Dr. Arun Nayak is Professor and Head of Department, LTMMC, Sion, Mumbai, India. He is senior Consultant Gynaecologist, Obstetrician and Laparoscopic Surgeon attached to LTM General Hospital, Surya and Cloud 9 Hospital. He is Past President of Mumbai Obstetrics and Gynaecology Society (MOGS), Secretary of AMOGS and Joint Assistant Editor of JOGI. His main area of interest is Laparoscopic and Urinary Incontinence surgeries for which he has received special training
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