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Placenta Percreta

The most severe form of the PAS spectrum, in which placental villi cross the serosa and may invade adjacent organs.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kadın Hastalıkları ve Doğum department. Book Appointment →

What is Placenta Percreta?

Placenta percreta is the most severe PAS form, in which placental invasion crosses the uterine serosa and reaches surrounding tissues and organs (especially the bladder). Its incidence is rising in parallel with increasing cesarean rates.

Diagnosis uses prenatal ultrasonography and MRI together. MRI shows loss of the uterovesical interface, bladder wall thickening and irregularity, and abnormal vascularity. Hematuria provides an additional clinical clue.

In management, planned cesarean hysterectomy is the gold standard. Risks of urological injury, massive hemorrhage and disseminated intravascular coagulation (DIC) are high. Transfusion reserves, interventional radiology, urology and vascular surgery are jointly planned.

Symptoms

Painless vaginal bleeding
Hematuria (in bladder invasion)
Lower abdominal pain
Bladder wall invasion on ultrasonography
Loss of uterovesical interface on MRI
Sudden obstetric shock
Signs of intra-abdominal bleeding

Risk Factors

History of three or more cesareans
Coexisting placenta previa
History of prior percreta
Uterine surgery and scarring
Advanced maternal age
Pregnancies achieved by IVF

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Hematuria together with bleeding in pregnancy
  • Combination of placenta previa and multiple cesareans
  • Suspicious findings of percreta on ultrasound/MRI
  • Early presentation for routine prenatal follow-up
  • When sudden abdominal pain and shock develop

Treatment Methods

01
Prenatal MRI and multidisciplinary planning
02
Planned cesarean hysterectomy (early delivery at 34-36 weeks)
03
Urology and vascular surgery assistance
04
Arterial balloon occlusion catheters (selected cases)
05
Massive transfusion and cell saver
06
Long-term intensive care and follow-up

Which Department to Visit?

You can visit our Kadın Hastalıkları ve Doğum department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Kadın Hastalıkları ve Doğum Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.