Antepartum diagnosis of placenta previa percreta by magnetic resonance imaging.

Abstract

Placenta previa percreta is a rare but highly morbid condition usually diagnosed intraoperatively. Placental manipulation results in severe bleeding. Magnetic resonance imaging (MRI) might allow antepartum diagnosis of this condition. A multiparous woman with five previous abdominal deliveries had complete placenta previa diagnosed at 16 weeks' gestation. Bleeding ensured at 29 weeks and she was managed with bed rest. Before planned abdominal delivery, MRI was performed and placenta percreta was diagnosed, which allowed her physician to avoid placental manipulation. Hysterectomy was accomplished with an estimated blood loss of only 2000 mL. Antepartum diagnosis of placenta previa percreta by MRI altered the usual diagnostic and surgical approach, diminishing blood loss and morbidity.