title: Spontaneous uterine rupture at non-cesarean section scar site with placenta percreta in the second trimester: a case report.
abstract: BACKGROUND
  Uterine rupture was a common occurrence at previously cesarean-sectioned scar Early sign ofuterine rupture was a severe fetal bradycardia.
  
  
  METHODS
  A 30-year-old, 3 gravida, 1 para woman was presented with an acute abdominal pain and hypovolemic shock. Her gestational age was estimated at 18 weeks by emergency pelvic ultrasound. She had a lower segment scar from a previous caesarean section. Initially, alive intrauterinepregnancy with massive hemoperitoneum was a provisional diagnosis. During exploratory laparotomy, a ruptured of the right uterine fundus was found with placenta percreta. Hysterectomy was performed. Fetal weight was 450 grams, APGAR score 0, 0 and the fetus could not survive. The patient was discharged on the 4th day after surgery in healthy condition.
  
  
  CONCLUSIONS
  Uterine rupture is a catastrophic kituation. Severefetal bradycardia might be an early sign. This case demonstrates the importance ofclinical judgment based on clinical acumen.
authors.forename: Komsun
authors.initials: K
authors.lastname: Suwannarurk
authors.forename: Densak
authors.initials: D
authors.lastname: Pongrojpaw
authors.forename: Sakol
authors.initials: S
authors.lastname: Manusook
authors.forename: Worapop
authors.initials: W
authors.lastname: Suthiwartnarueput
authors.forename: Kornkarn
authors.initials: K
authors.lastname: Bhamarapravatana
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007044:Hysterectomy; D010921:Placenta Accreta; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D014597:Uterine Rupture / Q000209:etiology* / Q000601:surgery