Nearly fatal uterine rupture during manual removal of the placenta: a case report.
BACKGROUND
A uterine scar is a well-known riskfactorfor both abnormal placentation and uterine rupture, both of which may lead to a serious obstetric hemorrhage.


METHODS
A 23-year-old woman, gravida 2, para 0 with a history of first-trimester dilatation and curettage (D&C) experienced a life-threatening obstetric hemorrhage due to uterine rupture during manual removal of a placenta increta. Cessation of the bleeding occurred only following secondary embolization after hysterectomy.


CONCLUSIONS
Obstetricians should be aware of the risk of uterine scarring and abnormal placentation in women who have undergone D&C, as it could lead to a life-threatening obstetric hemorrhage.
Zwart
Joost J
JJ
Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands. j.j.zwart@lumc.nl
van Huisseling
Hans C M
HC
Schuttevaer
Herman M
HM
van Roosmalen
Jos
J
Oepkes
Dick
D
D000328:Adult; D000792:Angiography; D002921:Cicatrix / Q000150:complications*; D036861:Delivery, Obstetric / Q000009:adverse effects*; D004107:Dilatation and Curettage / Q000009:adverse effects*; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007044:Hysterectomy; D010921:Placenta Accreta; D006473:Postpartum Hemorrhage / Q000209:etiology* / Q000628:therapy*; D011247:Pregnancy; D012307:Risk Factors; D014597:Uterine Rupture / Q000209:etiology* / Q000601:surgery