Haematuria from early pregnancy in a morbidly adherent placenta: Case report and a short review

Abstract

The morbidly adherent placenta has evolved into one of the potentially life-threatening conditions in obstetrics. Vaginal bleeding is the most common presentation of placenta percreta. Other symptoms include unusual dull, prolonged lower abdominal pain. Although haematuria is rare, it may be a presentation of the morbidly adherent placenta in early pregnancy. We report a case of placenta percreta with a very uncommon presentation of gross haematuria early in the second trimester managed successfully. It is emphasized that a high index of suspicion, ultrasound, and/or MRI can establish a preoperative diagnosis of the invasive placenta earlier. However, the diagnostic accuracy of cystoscopy is still under debate. With timely diagnosis, preparedness, and multidisciplinary care, it is possible to minimize catastrophic complications.

Vesicouterine adherence is independent of the degree of villi implantation: A retrospective case-control study

“…However, these local neovascularity are often immature and friable 21,22 and are easily susceptible to rupture either spontaneously or during surgical manipulation which usually results in massive hemorrhage. This could explain the signi cant association between the depth of villi of implantation and blood loss observed in our study (p = 0.046) and the occurrences of spontaneous hematuria in PAS cases with bladder adherence reported in literature [23][24][25] . However, such overt hypervascularity are absent in low grade PAS regardless of the presence of vesicouterine adherence, which correlated with a signi cantly reduced incidence of signi cant blood loss (p < 0.001).…”