title: Placenta increta/percreta associated with uterine perforation during therapy for fetal death. A case report.
abstract: BACKGROUND
  Placenta accreta involves abnormal adherence of the placenta to the myometrium. Placenta increta and percreta are defined by the degree of trophoblastic penetration of the myometrium. These conditions are rarely observed in the first trimester; placenta increta and percreta are exceptionally infrequent.
  
  
  METHODS
  A woman had a uterine perforation after suction curettage for fetal death at 11 weeks' gestation, requiring hysterectomy for control of a profuse hemorrhage. Histopathologic examination of the uterus revealed placenta increta involving the lower uterine segment and placenta percreta at the site of uterine perforation.
  
  
  CONCLUSIONS
  This is the first report of placenta percreta associated with uterine perforation during therapy for first-trimester fetal death.
authors.affiliation: Departments of Obstetrics and Gynecology and of Pathology, Wilford Hall United States Air Force Medical Center, Lackland Air Force Base and Brooke Army Medical Center, Ft. Sam Houston, Texas, USA.
authors.forename: S M
authors.initials: SM
authors.lastname: Carlton
authors.forename: C M
authors.initials: CM
authors.lastname: Zahn
authors.forename: B S
authors.initials: BS
authors.lastname: Kendall
authors.forename: S
authors.initials: S
authors.lastname: Natarajan
mesh_terms: D000328:Adult; D005260:Female; D005313:Fetal Death; D006801:Humans; D007044:Hysterectomy; D010921:Placenta Accreta / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D019106:Postoperative Hemorrhage / Q000209:etiology; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D014595:Uterine Perforation / Q000209:etiology*; D014619:Vacuum Curettage / Q000009:adverse effects*