Spontaneous rupture of unscarred uterus in the early second trimester: a case report of placenta percreta.
BACKGROUND
Prevalence of uterine rupture at delivery has been recently estimated at less than 1 in 2500 deliveries. Spontaneous uterine rupture in the early mid-trimester (16 weeks gestation or less), is far less frequent. We report a case of uterine rupture due to placenta percreta in otherwise uncomplicated pregnancy


METHODS
A 35-year-old, gravida 5, para 5, at 15wk 2d gestation (menstrual age) with negative history of uterine scarring suddenly developed symptoms of incipient hypovolemic shock while being hospitalized for imminent miscarriage. On exploratory laparotomy we found a midline uterine rupture infiltrated by the placenta. Supracervical hysterectomy was performed. Postoperative lab analysis confirmed the elevated serum AFP levels.


CONCLUSIONS
Abnormal placentation and subsequent uterine rupture should be taken into consideration also in women in the second trimester who have no history of uterine instrumentation.
Department of Reproductive Medicine and Gynaecological Endocrinology, Medical University of Bialystok, Poland. piotr.pierzynski@gmail.com
Piotr
P
Pierzynski
Piotr
P
Laudanski
Adam
A
Lemancewicz
Stanislaw
S
Sulkowski
Tadeusz
T
Laudanski
D000328:Adult; D005260:Female; D006801:Humans; D007044:Hysterectomy; D010921:Placenta Accreta / Q000097:blood / Q000473:pathology* / Q000601:surgery*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D016896:Treatment Outcome; D014597:Uterine Rupture / Q000473:pathology / Q000601:surgery; D014599:Uterus / Q000473:pathology; D000509:alpha-Fetoproteins / Q000032:analysis
D000509:alpha-Fetoproteins