Journal of Postgraduate Medicine, Education and Research

Register      Login

VOLUME 50 , ISSUE 4 ( October-December, 2016 ) > List of Articles

CASE REPORT

Successful Multimodality Life-saving Management of Placenta Percreta with Hemoperitoneum in Shock

Kajal Jain, Neelam Aggarwal, Navneet Kumar, Sujata Siwatch, Ujjwal Gorsi

Citation Information : Jain K, Aggarwal N, Kumar N, Siwatch S, Gorsi U. Successful Multimodality Life-saving Management of Placenta Percreta with Hemoperitoneum in Shock. J Postgrad Med Edu Res 2016; 50 (4):201-203.

DOI: 10.5005/JPMER-50-4-201

Published Online: 01-12-2015

Copyright Statement:  Copyright © 2016; The Author(s).


Abstract

Introduction

Placenta percreta is rare but may present with life-threatening emergencies.

Case Report

We present a near-miss case with a placenta percreta presenting with hemoperitoneum and shock and describe how multidisciplinary multimodality management was used to save the lady in a tertiary care center of a low-resource setting. Peripartum hysterectomy with bilateral internal iliac ligation could not completely control the oozing. The general condition of the patient was poor with acidosis, coagulopathy, and hypothermia. Pelvic packing followed by embolization was done along with intensive care to treat metabolic derangements. It helped salvage the patient who later underwent a relaparotomy for pack removal. Conclusion and clinical significance: Role of individualized multimodality multidisciplinary management and intensive care is emphasized.

How to cite this article

Chopra S, Siwatch S, Jain K, Aggarwal N, Gorsi U, Kumar N. Successful Multimodality Life-saving Management of Placenta Percreta with Hemoperitoneum in Shock. J Postgrad Med Edu Res 2016;50(4):201-203.


PDF Share
  1. The pathology of placenta accreta, a worldwide epidemic. J Clin Pathol 2008 Dec;61(12):1243-1246.
  2. Changing trends in peripartum hysterectomy over the last 4 decades. Am J Obstet Gynecol 2009 Jun;200(6):632.e1-6.
  3. Emergency peripartum hysterectomy: incidence, indications, risk factors and outcome. N Am J Med Sci 2011 Aug;3(8):358-361.
  4. Placenta percreta: rare presentation of haemorrhage in the second trimester. BMJ Case Rep 2013 Feb;2013.
  5. The 1-2-3 approach to abdominal packing. World J Surg 2012 Dec;36(12):2761-2766.
  6. Pelvic packing. J Visc Surg 2013 Sep;150(4):257-262.
  7. Pelvic packing with vaginal traction for the management of intractable hemorrhage. Int J Gynaecol Obstet 2014 Oct;127(1):21-24.
  8. Effective use of the Bakri postpartum balloon for posthysterectomy pelvic floor hemorrhage. Am J Obstet Gynecol 2014 Jun;210(6):586.e1-3.
  9. Abdomino-pelvic packing to control severe haemorrhage following caesarean hysterectomy. J Obstet Gynaecol 1999 Mar;19(2):155-158.
  10. Conservative multidisciplinary management of placenta percreta following in vitro fertilization. Obstet Gynecol Sci 2013 May;56(3):194-197.
  11. Placenta previa percreta with bladder involvement: new considerations and review of the literature. Ultrasound Obstet Gynecol 1997 Feb;9(2):131-138.
  12. Invasive placentation and uterus preserving treatment modalities: a systematic review. Arch Gynecol Obstet 2011 Aug;284(2):491-502.
  13. Posterior placenta percreta: blood supply and possibility of recurrence. J Obstet Gynaecol Res 2011 Jun;37(6):670.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.