Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012:2012:251381.
doi: 10.1155/2012/251381. Epub 2012 Oct 14.

Placenta percreta invading broad ligament and parametrium in a woman with two previous cesarean sections: a case report

Mansoureh Vahdat  1 , Abolfazl Mehdizadeh, Elaheh Sariri, Shahla Chaichian, Zahra Najmi, Maryam Kadivar
Affiliations

Placenta percreta invading broad ligament and parametrium in a woman with two previous cesarean sections: a case report

Mansoureh Vahdat et al. Case Rep Obstet Gynecol. 2012.

Abstract

Introduction. The incidence of placenta accreta has dramatically increased due to increasing caesarean section rate all over the world. Placenta percreta is the most severe form of placenta accretes. It frequently results in maternal morbidity and mortality mainly caused by massive obstetric hemorrhage or emergency hysterectomy. Percreta invading into the broad ligament has rarely been previously reported. Case presenting. We presented a case of placenta percreta invading left broad ligament and parametrium in a woman with two previous cesarean sections, which led to massive intraoperative hemorrhage during hysterectomy and transient ischemic encephalopathy. Conclusion. In cases of parametrial involvement, it would be more difficult to decide whether to remove placenta or leave it in site. In surgical removal neither local excision of placental bed and uterine repair nor traditional hysterectomy is adequate if parametrium invaded by placenta. We suggest delayed elective hysterectomy in such cases. So, pregnancy-induced pelvic congestion would be decreased, we can gather an expert team of gynecologists, urologists, and vascular surgeons, we could get plenty of blood products, and we may have the chance to administer methotrexate.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Ultrasound feature of percreta, in 37th week of gestation. Arrow shows lacunas in placenta.
Figure 2
Figure 2
Placenta invading left broad ligament and parametrium. Arrow is pointed to the placenta.
Figure 3
Figure 3
Pathologic feature shows placenta increta.
See this image and copyright information in PMC

References

    1. O’Brien JM, Barton JR, Donaldson ES. The management of placenta percreta: conservative and operative strategies. American Journal of Obstetrics and Gynecology. 1996;175(6):1632–1638. - PubMed
    1. Honig A, Rieger L, Thanner F, Eck M, Sutterlin M, Dietl J. Placenta percreta with subsequent uterine rupture at 15 weeks of gestation after two previous cesarean sections. Journal of Obstetrics and Gynaecology Research. 2005;31(5):439–443. - PubMed
    1. Wu S, Kocherginsky M, Hibbard JU. Abnormal placentation: twenty-year analysis. American Journal of Obstetrics and Gynecology. 2005;192(5):1458–1461. - PubMed
    1. Seoud M, Cheaib S, Birjawi G, Tawil A, Jamali F. Successful treatment of severe retro-peritoneal bleeding with recombinant factor VIIa in women with placenta percreta invading into the left broad ligament: unusual repeated ante-partum intra-abdominal bleeding. Journal of Obstetrics and Gynaecology Research. 2010;36(1):183–186. - PubMed
    1. Lin CC, Adamczyk CJ, Montag AG, Zelop CM, Snow JC. Placenta previa percreta involving the left broad ligament and cervix: a case report. Journal of Reproductive Medicine for the Obstetrician and Gynecologist. 1998;43(9):839–843. - PubMed

LinkOut - more resources