Placenta percreta is the most dreadful form of placental accreta syndrome. It is a variant of placenta accreta in which chorionic villi penetrates the entire thickness of the myometrium through the uterine serosa and may involve the adjacent structures. A 31 years old second gravida with previous one LUCS came to GOPD at 30 weeks POG with C/O mild lower abdominal pain. She was already diagnosed with placenta percreta at USG FPP of 12 weeks 6days. Despite all the risks and possibilities counselled during first diagnosis, she wanted to continue the pregnancy. At 30 weeks of POG with mild lower abdominal pain, she was admitted with a plan to continue the pregnancy till 34weeks under strict monitoring. But on the third day of admission, the intensity of lower abdominal pain increased with increased supra-pubic tenderness with clinical signs of impending scar rupture. Patient was taken for immediate intervention. During OT, it was diagnosed as a case of scar rupture with placental tissue popping out. Baby delivered by classical section, followed by bilateral internal iliac artery ligation and peripartum hysterectomy. Internal iliac ligation prior to hysterectomy reduced intra-operative blood loss, improving the maternal outcome and decreasing the maternal morbidity.

Keywords: obstetric hysterectomy, poft CS, placenta previa

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