Placenta percreta with urinary bladder involvement.

A 37-year-old Pakistani lady, who had previously undergone one cesarean delivery and one uterine curettage, was admitted to the labor ward at 29 weeks of gestation with history of a sudden severe painless vaginal bleeding from a sonographically diagnosed placenta previa. An immediate cesarean section was performed and a live male infant was delivered. The placenta was morbidly adherent to the lower uterine segment and attempts at removal caused torrential bleeding, necessitating cesarean hysterectomy. In addition, attempts to dissect the bladder from the lower uterine segment were unsuccessful and, hence, the diagnosis of placenta percreta with involvement of the urinary bladder was made. A modified posterior approach to the hysterectomy was carried out, with subsequent good recovery.