Background: Adherent placentas including placenta accreta, increta and percreta are conditions where there is abnormal implantation of all or part of the placenta on the myometrial wall. Massive adherent placenta has high morbidity and mortality rates in both mother and fetus. There is a positive correlation between the incidence of adherent placenta and the increase in cesarean section rates worldwide. Identification of risk factors, antenatal diagnosis, accurate preoperative preparation, multidisciplinary management, and appropriate counseling are the main management of adherent placenta to reduce maternal morbidity. Case Presentation: A woman, G5P3A1, age 36 years pregnant 37 weeks, complained loudly regularly since 6 hours before admission to hospital. There is a history of CS as much as 3x with indications of 2x Premature rupture of the membranes and uterine rupture, as well as a history of curettage (1x). Physical examination showed that the general condition was good, and composting, vital signs were within normal limits. Abdomen palpable single fetus, intrauterine, elongated, head presentation, left back, moderate his (+), FHR 150 x/minute. The results of prenatal sonography examination showed that neither placenta previa nor massive adherent placenta was found. The preoperative diagnosis was inparticular stage I latent phase with a history of SC 3 times. Results: An emergency Caesarean section was performed. Durante surgery showed severe adhesions of the placenta, uterine wall and bladder. The diagnosis of placenta percreta was confirmed, uterine resection was performed on the perreta section, hysterography as well as adhesiolysis and MOW sterilization. The results of the PA examination support the diagnosis of placenta percreta. Conclusion: Massive adherent placenta, placenta percreta was not diagnosed in this case because there were no clinical features or prenatal sonography that supported the diagnosis of placenta percreta. A history of trauma to the uterus due to uterine rupture, history of CS and curettage were risk factors for placenta percreta in this case. The incidence rate of placenta percreta with a history of SC 3 times without placenta previa on the previous sonographic examination was 0.1%. Operative management to manage bleeding and post operative care have been carried out according to the procedure so as to avoid mortality. Keywords: massive adherent placenta, placenta percreta, case report Correspondence: Eric Edwin Yuliantara. Department Obstetrics and Gynecology, Faculty of Medicine Universitas Sebelas Maret/ dr. Moewardi General Hospital Surakarta. Jl Kolonel Sutarto 132, Surakarta, Central Java. Email: edwinericog- @staff.uns.ac.id. Mobile: 08122618769.

Background: Family planning acceptor's understanding of intra uterine device (IUD) and implant contraception is still low, due to the lack of knowledge and negative perceptions about IUD and implants contraception in the society. Therefore, it needs an effort to increase the understanding of family planning acceptors to reduce fertility rates through increasing the use of contraception. This study aimed to analyze understanding and satisfaction of family planning acceptors with the satisfaction aspects of counseling, the comfortable effect on the insertion of contraceptives, and the satisfaction of family planning services at the Solo Peduli Clinic. Subjects and Method: A cross sectional study was conducted at Solo Peduli Clinic, Surakarta, Central Java, from June to August 2020. A sample of 60 women divided into 2 groups: (1) 30 women who have used IUD and implant contraceptives, and (2) 30 women that will be given counselling and insertions of IUD and implant contraceptives. The study subject was selected by fixed disease sampling. The dependent variable was satisfaction. The independent variables were counselling, comfortable effect, and family planning service.The data were collected by questionnaire and analyzed by a multiple logistic regression run on SPSS ver. 25. Results: The average level of satisfaction of counseling, the comfortable effect of using contraceptives, and satisfaction with family planning services has an "very satisfied". Good counselling (OR= 1.592; 95% CI= 1.097 to 2.310; p= 0.014), insertion convenience (OR= 1.428; 95% CI= 0.976 to 2.090; p= 0.066), and good family planning service (OR= 1.761; 95% CI= 1.191 to 2.603; p= 0.004) increased satisfaction. Conclusion: Good counselling, insertion convenience, and good family planning service increase satisfaction.