Placenta percreta – a near miss

Gundewar T, Kale Y, Ghike S, Gundewar S


A type of morbidly adherent placenta in which chorionic villi completely invade the myometrium and may invade the serosa or adjoining organs, is known as Placenta Percreta. It is a very rare pregnancy problem and is associated with a high maternal and fetal morbidity and mortality. We present a case of placenta praevia percreta with massive intra-partum hemorrhage requiring an emergency cesarean hysterectomy.
Keywords: Morbidly adherent Placenta, Placenta Percreta, Cesarean Hysterectomy.

Full Text:



Hughes EC, editor. Obstetric- Gynecologic terminology with section on neonatology & glossary on congenital anomalies Philadelphia (PA) F.A.Davis, 1972.

Read JA, Cotton DB, Miller FC. Placenta Accreta: Changing clinical aspects & outcome.Obstet Gynecol 1980;56:31-4.

Miller DA, Chollet JA, Goodwin TM. Clinical risk factors for placenta praevia – placenta accrete. Am J Obstet Gynecol 1997;177:210-4.

R. Faranesh, R. Shabtai, S. Eliezer, and S. Raed, “Suggested approach for management of placenta percreta invading the urinary bladder,”Obstetricsand Gynecology 2007; vol.110,no.2,pp. 512–515.

G. Daskalakis, E. Anastasakis, N. Papantoniou, S. Mesogitis, M. Theodora, and A. Antsaklis, “Emergency obstetric hys- terectomy,” Acta Obstetricia et Gynecologica Scandinavica 2007; vol. 86, no. 2, pp. 223–227,

Hudson L, Belfort MA, Broome DR. Diagnosis and management of placenta percreta: a review. Obstetrical and Gynecological Survey 1998; 53(8): 509–517

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.

Sumigama S,Itakura A, Ota T. Placenta previa increta/percreta in Japan: a retrospective study of ultrasound findings, management and clinical course. Journal of Obstetrics and Gynaecology Research 2007; 33 (5): 606–611..

Eller AG, Porter TT,Soisson P, Silver RM. Optimal management strategies for placenta accreta. An International Journal of Obstetrics and Gynaecology 2009; 116(5) :648– 654.

Hudon L. Diagnosis & management of placenta percreta: a review. Obstet Gynecol 1998;53:509-17.

Wadhwa L, Gupta S, Gupta P. Morbidly Adherent Placenta (MAP): Lessons learnt. Open Journal of Obstetrics and Gynecology 2013; 3: 217-221.

RCOG Green-top guidelines No 27, December 2011.

Comstock CH. Antenatal diagnosis of placenta accreta: a review. Ultrasound Obstet Gynecol 2005; 26: 89-96.

Nighat Sultana, Sobia Mohyuddin, Tahira Jabbar. Management and maternal outcome in morbidly adherent placenta. J Ayub Med Coll Abbottabad 2011;

(2): 14-18.

Fitzpatrick KE, Sellers S, Spark P, Kurinczuk JJ, Brocklehurst P, Knight M. The management and outcomes of placenta accreta, increta, and percreta in the UK: a population-based descriptive study. BJOG. 2014 Jan;121(1):62-70;

Rao AP, Bojahr H, Beski S, MacCallum PK, Renfrew I. Role of interventional radiology in the management of morbidly adherent placenta J Obstet Gynaecol. 2010;30(7):687-9.