Bladder Bleeding Due to Placenta Percreta: Report of Four Cases and Management Discussion

Abstract. Placenta percreta with bladder bleeding can occur during gestation or postpartum, posing a great threat to both mother and fetus. But it is rare and lacks standard management strategies. We reported four cases suffering from bladder bleeding caused by placenta percreta even with hemorrhagi...

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Autores principales:	Huidan Zhao, Xianlan Zhao, Chuanna Liu, Ya Tao, Yan Zhou, Yang Pan
Formato:	article
Lenguaje:	EN
Publicado:	Wolters Kluwer Health 2021
Materias:	Gynecology and obstetrics RG1-991
Acceso en línea:	https://doaj.org/article/9b165d2eadcf439888c811a4d5084e00
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spelling	oai:doaj.org-article:9b165d2eadcf439888c811a4d5084e002021-11-25T07:59:21ZBladder Bleeding Due to Placenta Percreta: Report of Four Cases and Management Discussion2641-589510.1097/FM9.0000000000000120https://doaj.org/article/9b165d2eadcf439888c811a4d5084e002021-10-01T00:00:00Zhttp://journals.lww.com/10.1097/FM9.0000000000000120https://doaj.org/toc/2641-5895Abstract. Placenta percreta with bladder bleeding can occur during gestation or postpartum, posing a great threat to both mother and fetus. But it is rare and lacks standard management strategies. We reported four cases suffering from bladder bleeding caused by placenta percreta even with hemorrhagic shock admitted between January 1st, 2011 and December 31th, 2020 in The First Affiliated Hospital of Zhengzhou University. Clinical information, including age, gravidity and parity, ultrasound and magnetic resonance imaging manifestations, onset gestational age, bladder bleeding volume, clinical manifestations under bleeding, diagnosis, hemostatic methods, hospital stay, treatment cost, and prognosis, are presented. Two cases had bladder bleeding during the second trimester, respectively on the 22+3 and 23+5 weeks. Pregnancy was terminated timely. The other two cases had bladder bleeding on the 2nd day post near-term cesarean section when activity. All the four cases achieved successful hemostasis following angiography and concomitant embolization for iliac vessels, and one of them received electrocoagulation hemostasis under cystoscopy, but failed. They all had favorable clinical outcomes and had no long-term complications. The neonatal outcome in the two cases that bladder hemorrhage occurred after near-term c-section was good. The newborns did not survive in two cases in which bladder hemorrhage occurred at the second trimester of pregnancy. Timely termination of pregnancy is recommended when such a condition develops during gestation. Diagnosis of bladder bleeding is relatively easy, for it is characterized by fast speed and large volume, with concomitant distension of the lower abdomen, blood discharge from the urethral orifice, or the indwelling catheter. Interventional embolization is an effective means to treat bladder bleeding caused by placenta percreta, while electrocoagulation hemostasis under cystoscopy must be applied with great caution. For the pregnant women with a high risk of placenta percreta, timely and accurate diagnosis should be achieved during the gestational age, and bladder bleeding should be concerned when placenta penetrates through the anterior wall of uterus.Huidan ZhaoXianlan ZhaoChuanna LiuYa TaoYan ZhouYang PanWolters Kluwer HealtharticleGynecology and obstetricsRG1-991ENMaternal-Fetal Medicine, Vol 3, Iss 4, Pp 285-291 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Gynecology and obstetrics RG1-991
spellingShingle	Gynecology and obstetrics RG1-991 Huidan Zhao Xianlan Zhao Chuanna Liu Ya Tao Yan Zhou Yang Pan Bladder Bleeding Due to Placenta Percreta: Report of Four Cases and Management Discussion
description	Abstract. Placenta percreta with bladder bleeding can occur during gestation or postpartum, posing a great threat to both mother and fetus. But it is rare and lacks standard management strategies. We reported four cases suffering from bladder bleeding caused by placenta percreta even with hemorrhagic shock admitted between January 1st, 2011 and December 31th, 2020 in The First Affiliated Hospital of Zhengzhou University. Clinical information, including age, gravidity and parity, ultrasound and magnetic resonance imaging manifestations, onset gestational age, bladder bleeding volume, clinical manifestations under bleeding, diagnosis, hemostatic methods, hospital stay, treatment cost, and prognosis, are presented. Two cases had bladder bleeding during the second trimester, respectively on the 22+3 and 23+5 weeks. Pregnancy was terminated timely. The other two cases had bladder bleeding on the 2nd day post near-term cesarean section when activity. All the four cases achieved successful hemostasis following angiography and concomitant embolization for iliac vessels, and one of them received electrocoagulation hemostasis under cystoscopy, but failed. They all had favorable clinical outcomes and had no long-term complications. The neonatal outcome in the two cases that bladder hemorrhage occurred after near-term c-section was good. The newborns did not survive in two cases in which bladder hemorrhage occurred at the second trimester of pregnancy. Timely termination of pregnancy is recommended when such a condition develops during gestation. Diagnosis of bladder bleeding is relatively easy, for it is characterized by fast speed and large volume, with concomitant distension of the lower abdomen, blood discharge from the urethral orifice, or the indwelling catheter. Interventional embolization is an effective means to treat bladder bleeding caused by placenta percreta, while electrocoagulation hemostasis under cystoscopy must be applied with great caution. For the pregnant women with a high risk of placenta percreta, timely and accurate diagnosis should be achieved during the gestational age, and bladder bleeding should be concerned when placenta penetrates through the anterior wall of uterus.
format	article
author	Huidan Zhao Xianlan Zhao Chuanna Liu Ya Tao Yan Zhou Yang Pan
author_facet	Huidan Zhao Xianlan Zhao Chuanna Liu Ya Tao Yan Zhou Yang Pan
author_sort	Huidan Zhao
title	Bladder Bleeding Due to Placenta Percreta: Report of Four Cases and Management Discussion
title_short	Bladder Bleeding Due to Placenta Percreta: Report of Four Cases and Management Discussion
title_full	Bladder Bleeding Due to Placenta Percreta: Report of Four Cases and Management Discussion
title_fullStr	Bladder Bleeding Due to Placenta Percreta: Report of Four Cases and Management Discussion
title_full_unstemmed	Bladder Bleeding Due to Placenta Percreta: Report of Four Cases and Management Discussion
title_sort	bladder bleeding due to placenta percreta: report of four cases and management discussion
publisher	Wolters Kluwer Health
publishDate	2021
url	https://doaj.org/article/9b165d2eadcf439888c811a4d5084e00
work_keys_str_mv	AT huidanzhao bladderbleedingduetoplacentapercretareportoffourcasesandmanagementdiscussion AT xianlanzhao bladderbleedingduetoplacentapercretareportoffourcasesandmanagementdiscussion AT chuannaliu bladderbleedingduetoplacentapercretareportoffourcasesandmanagementdiscussion AT yatao bladderbleedingduetoplacentapercretareportoffourcasesandmanagementdiscussion AT yanzhou bladderbleedingduetoplacentapercretareportoffourcasesandmanagementdiscussion AT yangpan bladderbleedingduetoplacentapercretareportoffourcasesandmanagementdiscussion
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Bladder Bleeding Due to Placenta Percreta: Report of Four Cases and Management Discussion

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