Gross Hematuria, a rare manifestation of placenta percreta: a case report

Document Type : Case report

Authors

1 Associated professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

3 Resident, Department of Urology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction: Abnormal placental implantation with bladder invasion is a rare obstetric complication, which can be accompanied with severe maternal and fetal morbidity. Gross hematuria is a rare manifestation of these syndromes, placenta percreta. Awareness of rare and unusual manifestations of placenta accrete syndromes is crucial for effective and timely management of this condition. In this report, a case of placenta percreta with manifestation of gross hematuria is introduced.
Case presentation: The patient was a 32-year-old pregnant woman at 17 weeks of gestation and a history of two previous cesarean sections who was evaluated with MRI following gross hematuria and suspicion of abnormal placental adhesion. Hysterectomy was performed with the diagnosis of placenta percreta and due to severity of placental invasion.
 Conclusion: In the evaluation of a pregnant woman with gross hematuria, even as very early, especially with history of previous cesarean sections, awareness of probable diagnosis of placenta percreta with urinary tract involvement is needed for timely diagnosis and proper management.

Keywords

References

  1. Cunningham FG, Leveno KJ, Bloom SL, et al. Obstetrical hemorrhage. In: Cunningham FG, Gant NF, Leveno KJ, Gilstrap III LC, Hauth JC, Wenstrom KD. Williams obstetrics. 24nd ed. New York: McGraw-Hill; 2014.
  2. Pourali L, Golmohammadi M, Ayati S, Moeen Darbari S. Hysterectomy due to placenta accreta in a primigravid woman with increased maternal age: a case report. Iran J Obstet Gynecol Infertil 2015; 18(140):15-9.
  3. Konijeti R, Rajfer J, Askari A. Placenta percreta and the urologist. Reviews in urology 2009; 11(3):173.
  4. Washecka R, Behling A. Urologic complications of placenta percreta invading the urinary bladder: a case report and review of the literature. Hawaii Med J 2002; 61(4):66-9.
  5. Nageotte MP. Always be vigilant for placenta accreta. Obstetric Anesthesia Digest 2015; 35(3):146-7.
  6. Pagani G, Cali G, Acharya G, Trisch IT, Palacios-Jaraquemada J, Familiari A, et al. Diagnostic accuracy of ultrasound in detecting the severity of abnormally invasive placentation: a systematic review and meta-analysis. Acta Obstet Gynecol Scand 2018; 97(1):25-37.
  7. Bowman ZS, Eller AG, Kennedy AM, Richards DS, Winter TC 3rd, Woodward PJ, et al. Accuracy of ultrasound for the prediction of placenta accreta. Am J Obstet Gynecol 2014; 211(2):177.e1-7.
  8. Bahrami Taghanaki HR, Hashemian M, Lotfalizadeh M, Noras MR. The relationship between Body Mass Index (BMI) and birth weight and some pregnancy outcomes. Iran J Obstet Gynecol Infertil 2016; 19(30):1-8.
  9. Pourali L, Vatanchi A, Ayati S, Pezeshkirad M, Hashemnia F. Conservative management of invasive placental adhesion by prophylactic uterine artery embolization before cesarean section: report of 2 cases. Tehran University Medical Journal TUMS Publications 2017; 75(7):543-8.
  10. Matsuzaki S, Yoshino K, Endo M, Kakigano A, Takiuchi T, Kimura T. Conservative management of placenta percreta. Int J Gynaecol Obstet 2018; 140(3):299-306.
  11. Armstrong-Kempter S, Kapurubandara S, Trudinger B, Young N, Arrage N. A case of placenta percreta managed with sequential embolisation procedures. Case reports in obstetrics and gynecology 2018; (4):1-7.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 23, Issue 12
February 2021
Pages 98-101

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