{
    "abstract": "Placenta percreta, a rare variant of placenta accreta spectrum (PAS) disorders, poses a significant risk of life-threatening hemorrhage associated with the adherent placenta. Bladder involvement signifies an even rarer incidence and may sometimes present solely with gross hematuria. Therefore, it is imperative to consider both microscopic and gross hematuria during pregnancy as alarming signs. Among 342 cases of PAS admitted to our hospital between 2016 and 2023, 48 patients were diagnosed with placenta percreta. Two patients, one at 18\u2009weeks and the other at 25\u2009weeks of pregnancy, were referred to our tertiary care center due to severe gross hematuria. Following thorough preoperative evaluation, both pregnancies were terminated due to their unstable conditions. The first case underwent an elective supracervical cesarean hysterectomy at the 19th week of gestation, while the second case underwent an emergency total cesarean hysterectomy due to lack of response to blood transfusions. Both procedures included bilateral internal iliac artery ligation. Postoperatively, patients recovered without any complications; however, the fetuses did not survive. Placenta percreta, protruding into the bladder, can lead to severe hematuria at any stage of pregnancy, increasing the risk of life-threatening hemorrhage. Therefore, both microscopic and macroscopic hematuria during pregnancy should be considered alarming signs that require immediate attention. Early involvement of a urologist and a multidisciplinary medical team is also essential in suspected or confirmed cases of placenta percreta, as immediate surgical intervention may be necessary to ensure patient safety.",
    "authors": [
        {
            "affiliation": "Department of Obstetrics and Gynecology, Shiraz University of Medical Sciences, Shiraz, Iran.\nMaternal-fetal Medicine Research Center, Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.",
            "firstname": "Shaghayegh Moradi",
            "initials": "SM",
            "lastname": "Alamdarloo"
        },
        {
            "affiliation": "Maternal-fetal Medicine Research Center, Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.\nInfertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.",
            "firstname": "Atefe",
            "initials": "A",
            "lastname": "Hashemi"
        },
        {
            "affiliation": "Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Baylor, College of Medicine, Houston, Texas, USA.",
            "firstname": "Kamran",
            "initials": "K",
            "lastname": "Hessami"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, Shiraz University of Medical Sciences, Shiraz, Iran.",
            "firstname": "Elham",
            "initials": "E",
            "lastname": "Askary"
        },
        {
            "affiliation": "Neonatal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.",
            "firstname": "Hamide",
            "initials": "H",
            "lastname": "Barzegar"
        },
        {
            "affiliation": "Department of Radiology, Division of Musculoskeletal Imaging and Intervention, University of Washington, Seattle, Washington, USA.\nThe OncoRad Research Core, Department of Radiology, University of Washington/Fred Hutchinson Cancer Center, Seattle, Washington, USA.",
            "firstname": "Sara",
            "initials": "S",
            "lastname": "Haseli"
        },
        {
            "affiliation": "Department of Radiology, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran.",
            "firstname": "Elahe",
            "initials": "E",
            "lastname": "Abbaspour"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2024 Japan Society of Obstetrics and Gynecology.",
    "doi": "10.1111/jog.16177",
    "journal": "The journal of obstetrics and gynaecology research",
    "keywords": [
        "bladder involvement",
        "case report",
        "gross hematuria",
        "placenta accreta spectrum",
        "placenta percreta"
    ],
    "methods": null,
    "publication_date": "2024-12-05",
    "pubmed_id": "39632080",
    "results": null,
    "title": "Gross hematuria and placenta percreta: Report of two cases and literature review.",
    "xml": "<Element 'PubmedArticle' at 0x78850477ef70>"
}