In the case of an aggressive pre-placenta, it is usually important to know from the medical history first if the mother was a pregnant woman who had a cesarean delivery, and if the first one was a cesarean delivery, we will look early to see where her gestational sac is lodged to rule out a scar pregnancy. Because of the scar pregnancy, the possibility of placental implantation in the future is very high. If the weeks are now relatively large and you miss the early ultrasound, you have to take an ultrasound in the middle stage to see if there is placenta praevia. If the placenta is attached to the anterior wall, especially if the anterior wall of the low lying placenta or the anterior wall of the central placenta is predominant, there is still a possibility of implantation of the placenta, which is what we call a fatal placenta praevia. The risk of an aggressive placenta praevia is that the placenta may implant deeper, that is, the placental tissue may implant into the superficial or deep myometrium. In some patients, the entire myometrium may penetrate and even go to the bladder. The bleeding is very aggressive during surgery in such patients, and sometimes the bladder is damaged, and even when it is difficult to preserve the uterus, we remove the uterus to save lives. After hospitalization, an MRI is usually done to determine the location of the placenta and the depth of implantation, and an ultrasound is done to check the relationship between the placenta and the bladder. After admission, a series of preoperative preparations will be made, because the risk is very high, and even in some patients with more bleeding, the uterus will be removed.