Nagina Fatima Liaquat, Samia Shuja, Tabussum Shoaib.
Placenta Percreta- a rare catastrophe.
J Surg Pak Jan ;11(2):67-70.

Objective: To document the clinical presentation, risk factors, management and management of placenta percreta. Design: Case series Place and Duration of Study: A 5 year study from January 2001 to December 2005 in Gynaecology & Obstetrics department, Unit II, Jinnah Postgraduate Medical Centre, Karachi. Patient and Methods: This study included patients of placenta percreta who were either diagnosed on ultrasound during antenatal period or accidentally found atexploratory laparotomy or caesarean section. A total of 11 cases of placenta percreta were managed during the study period. The frequency of the lesion was 1: 2058 deliveries. In 7 patients placenta had invaded and perforated the uterine wall, in 3 patients it had invaded the urinary bladder as well and in one patient there was broad ligament invasion. Most common risk factors were previous caesarean section (CS) in 91% cases and placenta previa (91%) followed by curettage (9%). Hysterectomy was performed in all patients. Partial cystectomy and bladder repair was done in those cases where urinary bladder was invaded. Urinary bladder injury occurred un two (27.27%) patients. Two patients died, one due to irreversible shock and other due to acute renal failure. Conctusion: Placenta percreta is a rare catastrophe associated with high maternal morbidity and mortality. Early diagnosis and surgery following adequate resuscitation should be accomplished with multidisciplinary team.

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