Hematuria: An Unusual Presentation of Placenta Percreta

Gupta, Pooja; Pradeep, Yashodhara; Goel, Apul; Singh, Renu

doi:10.1016/j.urology.2012.05.008

Cited by 5 publications

(2 citation statements)

References 4 publications

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“…Intra-vesical clot is very rare and we could not think that it could be due to clot in bladder [1]. Sometime patients with plcacenta percreta can also present with haematuria [2]. In this part of India rupture uterus is very common because women try normal delivery from untrained dais with no proper back up and proper transport facility is not available.…”

Section: Discussionmentioning

confidence: 97%

A Case with Intra-Vesical Clot during Pregnancy Mimicking Rupture Uterus

Rani¹

2015

OGIJ

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A case with acute intravesical haemorrhage with obstructed uropathy is very challenging to diagnose during antenatal period, especially during labour. Here we are reporting a case with intravesical haemorrhage with obstructive uropathy in antenatal patient. Aim of presentation is awareness of this condition which is often difficult to differentiate from uterine rupture in obstructed labour. It can be diagnosed with emergency ultrasound if we had kept a differential diagnosis.

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Section: Discussionmentioning

confidence: 97%

A Case with Intra-Vesical Clot during Pregnancy Mimicking Rupture Uterus

Rani¹

2015

OGIJ

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“…Generally, it is quite rare to see bladder hemorrhage due to placenta percreta. So far, there are only three English reports [4][5][6] and one Chinese report 7 by now. The incidence rate of bladder hemorrhage due to placenta percreta has not been reported at home and abroad.…”

Section: Discussionmentioning

confidence: 99%

Bladder Bleeding Due to Placenta Percreta: Report of Four Cases and Management Discussion

Zhao

Liu

et al. 2021

Maternal-Fetal Medicine

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Placenta percreta with bladder bleeding can occur during gestation or postpartum, posing a great threat to both mother and fetus. But it is rare and lacks standard management strategies. We reported four cases suffering from bladder bleeding caused by placenta percreta even with hemorrhagic shock admitted between January 1 st , 2011 and December 31 th , 2020 in The First Affiliated Hospital of Zhengzhou University. Clinical information, including age, gravidity and parity, ultrasound and magnetic resonance imaging manifestations, onset gestational age, bladder bleeding volume, clinical manifestations under bleeding, diagnosis, hemostatic methods, hospital stay, treatment cost, and prognosis, are presented. Two cases had bladder bleeding during the second trimester, respectively on the 22 +3 and 23 +5 weeks. Pregnancy was terminated timely. The other two cases had bladder bleeding on the 2 nd day post near-term cesarean section when activity. All the four cases achieved successful hemostasis following angiography and concomitant embolization for iliac vessels, and one of them received electrocoagulation hemostasis under cystoscopy, but failed. They all had favorable clinical outcomes and had no long-term complications. The neonatal outcome in the two cases that bladder hemorrhage occurred after near-term c-section was good. The newborns did not survive in two cases in which bladder hemorrhage occurred at the second trimester of pregnancy. Timely termination of pregnancy is recommended when such a condition develops during gestation. Diagnosis of bladder bleeding is relatively easy, for it is characterized by fast speed and large volume, with concomitant distension of the lower abdomen, blood discharge from the urethral orifice, or the indwelling catheter. Interventional embolization is an effective means to treat bladder bleeding caused by placenta percreta, while electrocoagulation hemostasis under cystoscopy must be applied with great caution. For the pregnant women with a high risk of placenta percreta, timely and accurate diagnosis should be achieved during the gestational age, and bladder bleeding should be concerned when placenta penetrates through the anterior wall of uterus.

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Gross hematuria and placenta percreta: Report of two cases and literature review

Alamdarloo,

Hashemi,

Hessami

et al. 2024

J of Obstet and Gynaecol

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Placenta percreta, a rare variant of placenta accreta spectrum (PAS) disorders, poses a significant risk of life‐threatening hemorrhage associated with the adherent placenta. Bladder involvement signifies an even rarer incidence and may sometimes present solely with gross hematuria. Therefore, it is imperative to consider both microscopic and gross hematuria during pregnancy as alarming signs. Among 342 cases of PAS admitted to our hospital between 2016 and 2023, 48 patients were diagnosed with placenta percreta. Two patients, one at 18 weeks and the other at 25 weeks of pregnancy, were referred to our tertiary care center due to severe gross hematuria. Following thorough preoperative evaluation, both pregnancies were terminated due to their unstable conditions. The first case underwent an elective supracervical cesarean hysterectomy at the 19th week of gestation, while the second case underwent an emergency total cesarean hysterectomy due to lack of response to blood transfusions. Both procedures included bilateral internal iliac artery ligation. Postoperatively, patients recovered without any complications; however, the fetuses did not survive. Placenta percreta, protruding into the bladder, can lead to severe hematuria at any stage of pregnancy, increasing the risk of life‐threatening hemorrhage. Therefore, both microscopic and macroscopic hematuria during pregnancy should be considered alarming signs that require immediate attention. Early involvement of a urologist and a multidisciplinary medical team is also essential in suspected or confirmed cases of placenta percreta, as immediate surgical intervention may be necessary to ensure patient safety.

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Hematuria: An Unusual Presentation of Placenta Percreta

Cited by 5 publications

References 4 publications

A Case with Intra-Vesical Clot during Pregnancy Mimicking Rupture Uterus

A Case with Intra-Vesical Clot during Pregnancy Mimicking Rupture Uterus

Bladder Bleeding Due to Placenta Percreta: Report of Four Cases and Management Discussion

Gross hematuria and placenta percreta: Report of two cases and literature review

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