Placenta Percreta Grade 3D - Lifeline to Morbid Catastrophe: An Invincible Challenge to Contemporary Obstetrics

Q: What was the study design and how many patients were included?

The study is a case series including four patients diagnosed with placenta percreta.

Q: Why is prenatal diagnosis emphasized in placenta percreta?

Prenatal diagnosis is necessary to support multidisciplinary planning, which is described as particularly beneficial for appropriate management.

Q: What was the outcome in the reported cases?

In all included cases, hysterectomy was the outcome.

Sep 30, 2026

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The document presents a case series of four patients diagnosed with placenta percreta, managed in a tertiary-care obstetrics and gynecology unit in North India between March 2024 and May 2024, with pathologic confirmation. Prenatal diagnosis is emphasized for effective multidisciplinary planning, including an elective surgery pathway after DJ stenting in one case. Outcomes across all reported patients included hysterectomy, and the report highlights the clinical need for histopathology confirmation at delivery.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages4

Reading Time10 min

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Abstract

Introduction

Ultrasound and MRI role in prenatal diagnosis

Case Reports

Case 1

Case Series Placenta Percreta Grade 3D ‑ Lifeline to Morbid Catastrophe: An Invincible Challenge to Contemporary Obstetrics Abstract The global incidence of placenta accreta spectrum is increasing rapidly, mirroring the trend of increased cesarean delivery. We report a case series of four patients diagnosed with placenta percreta who presented to a single unit of the department of obstetrics and gynecology at a tertiary care center in North India from March 2024 to May 2024 with a pathologically proven diagnosis. In all cases, a hysterectomy was the outcome. We have included cases with prenatal diagnoses in this case series. For appropriate planning, a prenatal diagnosis of placenta percreta is necessary, as the multidisciplinary team’s approach is particularly beneficial. After DJ stenting, elective surgery was scheduled in one of the four instances. Keywords: Accreta, bladder invasion, percreta Introduction The placenta accreta spectrum (PAS) represents a serious complication associated with uterine surgery, with its incidence increasing from 0.12% to 0.31% over the past 30 years, largely attributed to the rising rate of cesarean sections.[1] Placenta accreta, increta, and percreta are all parts of a morbidly adherent placenta, which is caused by the placental trophoblast invading the uterus through the decidua basalis, penetrating the myometrium, and then migrating into the adjacent pelvic organs.[2] Because of its extensive invasion, placenta percreta is associated with higher maternal morbidity than the other placenta accreta subtypes (e.g., placenta accreta vera and placenta increta) .[3] The subjective interpretation of “typical”sonographic findings or signs using two‑dimensional grayscale and color Doppler imaging is the basis for current prenatal diagnosis. Many signs have been documented in research papers, exhibiting differing estimates of their specificity and sensitivity.[4] Ultrasound feature of placenta accreta in the 2nd and 3rd trimester include visualization of irregular vascular sinuses with turbulent This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License (CC BY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. For reprints [contact:](contact: WKHLRPMedknow_reprints@wolterskluwer.com)[ WKHLRPMedknow_reprints@wolterskluwer.com](contact: WKHLRPMedknow_reprints@wolterskluwer.com) flow, abnormalities of the bladder wall on ultrasonography (USG) inspection, and possibly, myometrial thickness of <1 mm.[4] Abnormal placental lacunae, loss of the retroplacental echo lucent zone, an irregular retroplacental echo lucent zone, a thinned or broken hyperechoic serosa bladder interface, and focal exophytic masses entering the bladder are all signs of placenta accretaon a grayscale USG scan.[1] Absence of echo lucent line between the placenta and myometrium is not a reliable sign. Diffuse or localized lacunar flow, a vascular lake with turbulent flow on color flow mapping (peak systolic velocity ≥15 cm/s), hypervascularity at the serosa bladder interface, and noticeably dilated arteries over the peripheral subplacental zone are among the color Doppler findings of placenta accreta.[5] When ultrasound findings are equivocal, magnetic resonance imaging (MRI) may help diagnose PAS that is situated in the posterior wall. Furthermore, because MRI can give more precise and in‑depth information on the placement of the placenta, the uterus, and the surrounding organs, it can aid in the planning of surgical techniques for PAS.[6] However, the final diagnosis can only be made clinically at delivery, and histopathology should be obtained to confirm the diagnosis. How to cite this article: Singh J, Rai S, Kumari P. Placenta percreta grade 3D - Lifeline to morbid catastrophe: An inv

FAQs

What was the study design and how many patients were included?

The study is a case series including four patients diagnosed with placenta percreta.

Why is prenatal diagnosis emphasized in placenta percreta?

Prenatal diagnosis is necessary to support multidisciplinary planning, which is described as particularly beneficial for appropriate management.

What was the outcome in the reported cases?

In all included cases, hysterectomy was the outcome.

Sep 30, 2026

Upload by CatatanPagi