Placenta percreta causing rupture of an unscarred uterus at the end of the first trimester of pregnancy: case report.
Reports on placenta percreta in early pregnancy leading to a spontaneous rupture of the uterus are rare. We report a case of this potentially life-threatening complication in the 14th week of pregnancy in an otherwise healthy woman who underwent a manual extraction of the placenta during a previous delivery but who had no history of severe pathology that could have potentially resulted in uterine damage. The occurrence of severe abdominal pain and the presence of a large quantity of free fluid in the abdomen necessitated an emergency laparotomy, revealing a haemoperitoneum due to rupture of the uterus, which was followed by a hysterectomy. This case demonstrates that in patients with a history of placenta accreta and subsequent manual extraction of the placenta, a close investigation of the uterine wall and placentation should be performed in the first trimester in order to anticipate a placenta percreta.
Esmans
A
A
Department of Obstetrics and Gynecology, Lindendreef 1, 2020 Antwerp, Belgium.
Gerris
J
J
Corthout
E
E
Verdonk
P
P
Declercq
S
S
D015746:Abdominal Pain / Q000209:etiology / Q000503:physiopathology; D000328:Adult; D002824:Chorionic Villi / Q000473:pathology; D005260:Female; D006465:Hemoperitoneum / Q000209:etiology; D006801:Humans; D007044:Hysterectomy; D009215:Myometrium / Q000473:pathology; D010921:Placenta Accreta / Q000150:complications* / Q000473:pathology; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D012422:Rupture, Spontaneous / Q000209:etiology / Q000601:surgery; D012720:Severity of Illness Index; D014591:Uterine Diseases / Q000209:etiology* / Q000601:surgery