Minimally Invasive Management of Second Trimester Placenta Percreta

79 Views | Sep 15, 2021

Authors: Siddhi Mathur, Wilson Chan, Meghan McGrattan, Lisa Allen, John Kingdom, Sebastian Hobson, Lindsay Shirreff, M.Jonathon Solnik, Ally Murji

Affliations: Mount Sinai Hospital, University of Toronto

Second trimester placenta percreta is a rare entity with very few case reports in the literature. They pose significant challenges in diagnosis and management. A minimally invasive approach has not been described in the literature. The objective of our video is to describe the diagnostic and surgical challenges in the management of second trimester placenta percreta. We discuss the case of a patient who presented with an acute abdomen and a bleeding placenta percreta at 17+2 weeks GA. Our video demonstrates the challenges of a minimally invasive approach. We describe five main challenges and a step wise approach to mitigating these challenges. In addition, we combine the use of a dilatation and evacuation technique to allow for a complete minimally invasive hysterectomy. We demonstrate that a minimally invasive approach to management of midtrimester placenta percreta is a feasible option.

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