BACKGROUND: Placenta percreta, invasion of placental tissue through the uterine wall, is a rare but potentially fatal complication of pregnancy. Historically, the diagnosis was made at laparotomy, usually during Caesarean hysterectomy. CASE: We describe a case of placenta percreta, in which the placenta was allowed to remain fixed to the uterine wall. Antenatal ultrasound and magnetic resonance imaging techniques were used to establish the diagnosis and guide clinical management. Elective postoperative uterine artery embolization down balloon catheters was used to prevent postpartum hemorrhage and to promote involution and shedding of the placenta. After 6 months, the uterus had involuted to the nonpregnant state. CONCLUSION: New diagnostic imaging techniques may be used to guide conservative management of placenta percreta, thereby maintaining fertility and avoiding hemorrhage, blood transfusion, and hysterectomy.
BACKGROUND:Placenta percreta, invasion of placental tissue through the uterine wall, is a rare but potentially fatal complication of pregnancy. Historically, the diagnosis was made at laparotomy, usually during Caesarean hysterectomy. CASE: We describe a case of placenta percreta, in which the placenta was allowed to remain fixed to the uterine wall. Antenatal ultrasound and magnetic resonance imaging techniques were used to establish the diagnosis and guide clinical management. Elective postoperative uterine artery embolization down balloon catheters was used to prevent postpartum hemorrhage and to promote involution and shedding of the placenta. After 6 months, the uterus had involuted to the nonpregnant state. CONCLUSION: New diagnostic imaging techniques may be used to guide conservative management of placenta percreta, thereby maintaining fertility and avoiding hemorrhage, blood transfusion, and hysterectomy.