A Case Study on Placenta Percreta
Sai Aravind D*, Varshitha N, Ramesh G and Srinivasa Babu P
Department of Pharmacy Practice, Vignan Pharmacy College, Vadlamudi, India
*Corresponding author: Aravind DS, Department of Pharmacy Practice, Vignan Pharmacy College, Vadlamudi, India, Tel.: 08632118030; E-mail:
aravindpharmd@yahoo.com
Received date: 23 April, 2018; Accepted date: 7 May, 2018; Published date: 24 May, 2018
Copyright: ©2018 Aravind DS, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted
use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Placenta percreta is a serious pregnancy condition that occurs when blood vessels and other parts of the
placenta grow the deeply into the uterine wall. Placenta percreta is a rare but a life-threatening condition. Control of
massive haemorrhage is the first priority; however, the patient's desire for future fertility has to be taken into
consideration. Here we present a case where we had to do a quick subtotal hysterectomy because of torrential
bleed due to placenta percreta with severe abdominal pain.
Keywords: Placenta percreta; Hysterectomy
Introduction
Te placenta grows onto the upper part of the uterus and stays there
until your baby is born. During the last stage of labour, the placenta
separates from the wall of the uterus, and your contractions help push
it into the vagina (birth canal). Tis is also called the aferbirth.
Placenta percreta is a serious pregnancy condition that occurs when
blood vessels and other parts of the placenta grows deeply into the
uterine wall. In other words, the placental blood vessels innervate into
the uterine wall and gets attached to the uterus. Typically, the placenta
detaches from the uterine wall afer childbirth [1]. With Placenta
accreta part or the entire placenta remains frmly attached, this can
cause severe blood loss afer delivery. Placenta percreta and accreta are
the same conditions but the position of the placenta attaching to the
uterus is diferent. Due to this condition in most of the women was
sufering with anemia afer delivery to due severe blood loss and even
leads to death. While treating these cases the doctor looks for the risk
to beneft ratio and counsel the patient regarding the abortion and
hysterectomy.
Causes
Placenta percreta is thought to be related to abnormalities in the
lining of the uterus, typically due to miscarrying afer a C-section or
other uterine surgery. Tis might allow the placenta to grow too deeply
into the uterine wall, sometimes, however placenta occurs even
without the history of uterine surgery [2]. Te pregnancy afer the age
of 35 is also one of the rare cause for this condition [3].
Pathology
It is characterised by transmural extension of placental tissue across
the myometrium with serosal breach. Placenta invasion of the
myometrium is related to a thinned decidual endometrium at the site
of implantation and this can happen for a number of risk factors.
Risk Factors
Te risk factors of this condition are previous caesarean section,
placenta previa, advanced maternal age, uterine anomalies,
intrauterine adhesion bands, and other uterine and placental surgeries
[4].
Diagnosis
Placenta percreta is diagnosed by the radiological tests like
ultrasound or magnetic resonance imaging (MRI), NT scans [5].
Figure 1: NT scan of 21 year old female patient pain in abdomen at
right lower side on and of for one day, pain over the previous scar
site of caesarean delivery.
Case Study
A 21-year-old female patient was admitted in hospital with chief
complaints of pain in abdomen at right lower side on and of for one
day, pain over the previous scar site of caesarean delivery, she was
assessed as G3P2L1A0D1 with 33 weeks period of gestation with 2
LSCS, scar tenderness. Te doctor afer conducting NT scan diagnosed
as placenta percreta and with partial cystectomy. Te advised
treatment is hysterectomy (Figure 1).
Jo
u
r
n
a
l
o
f
P
h
a
r
m
a
c
e
u
ti
c
a
l
C
a
r
e
&
H
e
a
l
t
h
S
y
st
e
m
s
ISSN: 2376-0419
Journal of Pharmaceutical Care &
Health Systems
Aravind et al., J Pharma Care Health Sys 2018, 5:2
DOI: 10.4172/2376-0419.1000191
Case Study Open Access
J Pharma Care Health Sys, an open access journal
ISSN: 2376-0419
Volume 5 • Issue 2 • 191