ABSTRACT
Three cases are reported of placenta percreta with urinary bladder wall invasion.
All three patients had complete placenta previa and each had five previous cesarean
sections. Placental invasion caused a giant vesicouterine fistula in the first case.
The second patient had a cesarean hysterectomy and the placental portion that penetrated
the bladder wall was left to absorb spontaneously. The third patient underwent a cesarean
supracervical hysterectomy during which the bladder invasion was left undisturbed.
She received intraoperative methotrexate, and pelvic packing and bilateral hypogastric
ligation were helpful in hemorrhage control.
