Conservative management of placenta percreta: a stepwise approach.

Purpose: To describe a modified surgical approach in the form of stepwise cesarean section in placenta percreta.

Methods: We conducted a prospective observational study. A total of 71 patients with placenta percreta were subjected to the new stepwise surgical approach and uterine repair at the time of cesarean delivery.

Results: The procedure was successful in controlling the bleeding and preserving the patient's uterus in 65 (91.5%) women. Ten patients (14.1%) had urinary tract complications, nine (90%) were managed during cesarean section and one presented late in the form of vesicouterine fistula.

Conclusions: A stepwise cesarean section is safe and effective procedure that can be applied in placenta percreta.