title: Placenta Percreta Presenting with Delayed Haematuria.
abstract: Placenta percreta presents as life threatening complications with bladder invasion. A condition of placenta invading urinary bladder presented with differential diagnosis of gestational trophoblastic neoplasia on imaging and responded to chemotherapy. A 35-year-old primi-gravida presented at term with per vaginal bleeding. During caesarian section placental mass totally invading uterine myometrium was found. She was given single dose of Methotrexate. After 2 months she presented with gross haematuria with clot retention two times. Her MRI was suggestive of gestational trophoblastic neoplasia of size 19 X 10 X 13cm. Her beta-Human Chorionic Gonadotropin levels were 691.23 mIU/ml. She was given total four doses of methotrexate. At present size of mass was 1.6 X1.3X 1.1cm. Her beta Human Chorionic Gonadotropin level dropped down to 2mIU/ml. Patient was not willing for further intervention or for follow up.
authors.affiliation: Resident, Department of Urology, King's Edward Memorial Hospital and S.G.S. Medical College , Mumbai, India .
authors.forename: Vinayak Gorakhanath
authors.initials: VG
authors.lastname: Wagaskar
authors.affiliation: Resident, Department of Urology, King's Edward Memorial Hospital and S.G.S. Medical College , Mumbai, India .
authors.forename: Sudarshan Omprakash
authors.initials: SO
authors.lastname: Daga
authors.affiliation: Professor and Head, Department of Urology, King's Edward Memorial Hospital and S.G.S. Medical College , Mumbai, India .
authors.forename: Sujata Kiran
authors.initials: SK
authors.lastname: Patwardhan
keywords: Bladder invasion; Hysterectomy; Mass methotrexate; Placenta percreta
references.citation: Obstet Gynecol. 2005 Jan;105(1):67-76
references.pmid: 15625144
references.citation: J Ultrasound Med. 2008 Nov;27(11):1623-8
references.pmid: 18946102
references.citation: J Perinatol. 2006 Feb;26(2):135-7
references.pmid: 16435009
references.citation: Int J Gynaecol Obstet. 2005 Nov;91(2):162-3
references.pmid: 16126207
references.citation: Am J Obstet Gynecol. 2005 May;192(5):1458-61
references.pmid: 15902137
references.citation: Rev Urol. 2009 Summer;11(3):173-6
references.pmid: 19918343
references.citation: Urology. 2012 Aug;80(2):e13-4
references.pmid: 22743265
references.citation: Int J Gynaecol Obstet. 2002 Apr;77(1):77-8
references.pmid: 12053897
references.citation: J Turk Ger Gynecol Assoc. 2011 Jun 01;12(2):127-9
references.pmid: 24591976