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Difficulty of the surgical management of a case with placenta percreta invading towards parametrium
Author(s) -
Borekci Bunyamin,
Ingec Metin,
Kumtepe Yakup,
Gundogdu Cemal,
Kadanali Sedat
Publication year - 2008
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/j.1447-0756.2008.00780.x
Subject(s) - parametrium , medicine , placenta percreta , obstetrics , placenta , general surgery , pregnancy , fetus , cervix , cancer , genetics , biology
Abstract A 37‐year‐old woman was admitted due to vaginal bleeding at 25 weeks of gestation to our gynecology unit. Placenta percreta, which stems from posterior wall of the uterus, forming a mass in Douglas cavity and invading towards right parametrium was clinically diagnosed by exploration. Bilateral internal iliac artery ligation and supracervical hysterectomy could not prevent bleeding. A right radical parametrectomy was necessary to remove invaded parametrium and to control bleeding. The placenta percreta invading parametrium may need an extended hysterectomy procedure. Excess bleeding may be prevented by leaving the placenta in situ during surgery if the placenta percreta is diagnosed before termination of pregnancy, A classical incision may help leaving placenta is situ during operation.