title: Placenta percreta with concomitant uterine didelphys at 18 weeks of pregnancy: a case report and review of the literature.
abstract: OBJECTIVE
  The aim of this paper is to draw the attention of the clinicians on placenta percreta detected along with uterine anomalies in early second trimester.
  
  
  METHODS
  A 35-year-old, gravida 2 parity 1 woman at 18 weeks of pregnancy was admitted to our emergency unit with abdominal pain. In ultrasound exam, a live fetus compatible with 18 weeks of gestation, hemoperitoneum and a solid mass adjacent to the uterus were detected. An emergent laparotomy was decided because of hemorrhagic shock findings. In the operation, uterine didelphys and an active bleeding area from placenta percreta on the anterior wall of the uterus where pregnancy was settled were detected. In the simultaneous vaginal examination two cervixes and a longitudinal vaginal septum were seen. Supracervical hemihysterectomy was performed.
  
  
  CONCLUSIONS
  Placenta percreta is a rare clinical entity with an elevated perinatal mortality. Uterine anomalies are risk factors for placental adhesion anomalies. Clinical suspicion is vital for early diagnosis and timely management.
authors.affiliation: a Department of Obstetrics and Gyneacology , Ümraniye Medical and Research Hospital , İstanbul , Turkey.
authors.forename: Esra
authors.initials: E
authors.lastname: Tuştaş Haberal
authors.affiliation: a Department of Obstetrics and Gyneacology , Ümraniye Medical and Research Hospital , İstanbul , Turkey.
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Çekmez
authors.affiliation: a Department of Obstetrics and Gyneacology , Ümraniye Medical and Research Hospital , İstanbul , Turkey.
authors.forename: İpek
authors.initials: İ
authors.lastname: Ulu
authors.affiliation: a Department of Obstetrics and Gyneacology , Ümraniye Medical and Research Hospital , İstanbul , Turkey.
authors.forename: Radia
authors.initials: R
authors.lastname: Divlek
authors.affiliation: a Department of Obstetrics and Gyneacology , Ümraniye Medical and Research Hospital , İstanbul , Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Göçmen
mesh_terms: D000328:Adult; D005260:Female; D005865:Gestational Age; D006801:Humans; D007044:Hysterectomy; D007813:Laparotomy; D063130:Maternal Death / Q000517:prevention & control; D010921:Placenta Accreta / Q000175:diagnosis* / Q000601:surgery; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D012307:Risk Factors; D014592:Uterine Hemorrhage / Q000209:etiology; D014597:Uterine Rupture / Q000175:diagnosis* / Q000601:surgery; D014599:Uterus / Q000002:abnormalities*
keywords: Placenta percreta; uterine didelphys; uterine rupture