title: Uterine rupture after prior conservative management of placenta accreta.
abstract: BACKGROUND
  There is little evidence for counseling patients who seek uterine conservation in the setting of placenta accreta.
  
  
  METHODS
  We report the case of a 37-year-old woman with retained placenta accreta after vaginal delivery. Attempts at transvaginal removal failed, and the placenta was removed through a fundal hysterotomy with bilateral uterine artery ligations performed to control blood loss. She conceived a second pregnancy 11 months later and sustained spontaneous fundal uterine rupture at 26.5 weeks of gestation with a recurrent accreta found at the rupture site. The newborn survived but has residual musculoskeletal morbidity and developmental delay at 1 year of age.
  
  
  CONCLUSIONS
  Patients undergoing conservative treatment of placenta accreta in the setting of a fundal hysterotomy should be cautioned about recurrent accreta and uterine rupture.
authors.affiliation: Department of Obstetrics & Gynecology, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts.
authors.forename: Neha A
authors.initials: NA
authors.lastname: Deshpande
authors.forename: Daniela A
authors.initials: DA
authors.lastname: Carusi
mesh_terms: D000328:Adult; D002585:Cesarean Section; D002658:Developmental Disabilities / Q000209:etiology; D005260:Female; D059247:Fertility Preservation / Q000009:adverse effects; D006801:Humans; D020883:Hysterotomy / Q000009:adverse effects; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D008297:Male; D059351:Organ Sparing Treatments / Q000009:adverse effects*; D010921:Placenta Accreta / Q000601:surgery*; D011247:Pregnancy; D012008:Recurrence; D014597:Uterine Rupture / Q000209:etiology* / Q000601:surgery