A 40-year-old woman with a history of cesarean sec- tion and 3 episodes of uterine curettage for spontane- ous or induced abortion presented with massive geni-tal hemorrhage in the ninth week of gestation; she was treated with red cell concentrate and fresh frozen plasma transfusion. She was admitted to our hospital at the 11th week of gestation for continuous genital hemorrhage and cervical shortening (20 mm). Ultra- sonography revealed placenta previa totalis. A low- lying gestational sac in early pregnancy, vascular la- cunae, and an obscured retroplacental sonolucent zone indicated placenta percreta; magnetic resonance imaging showed similar findings. Owing to placenta percreta, uterus preservation was considered impos- sible. Elective cesarean section followed by total hys- terectomy was performed at the 37th week of gestation, with bilateral internal iliac artery balloon catheter occlusion for reducing blood loss. The perioperative blood loss was 2,835 mL, for which the patient re- ceived blood transfusion. The postoperative course was uncomplicated.
Keywords: Placenta Percreta; Massive