title: Escalating placenta invasiveness: repeated placenta accreta at the limit of viability.
abstract: Placenta percreta is an obstetric condition in which the placenta invades through the myometrium. This is the most severe form of placenta accreta and may result in spontaneous uterine rupture, a rare complication that threatens the life of both mother and fetus. In this case report, we describe a 32-year-old woman in her fourth pregnancy, diagnosed with repeated placenta accreta, which was eventually complicated by spontaneous uterine rupture at 24 weeks' gestation. This patient had a history of abnormal placentation in prior pregnancies and previous uterine injuries. This case demonstrates a pattern of escalating placental invasiveness, and raises questions regarding the process of abnormal placentation and the manifestation of uterine rupture in scarred uteri.
authors.affiliation: Department of Obstetrics and Gynecology, Soroka University Medical Center, School of Medicine, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
authors.forename: Shirley
authors.initials: S
authors.lastname: Greenbaum
authors.affiliation: Department of Radiology, Soroka University Medical Center, School of Medicine, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
authors.forename: Alla
authors.initials: A
authors.lastname: Khashper
authors.affiliation: Department of Obstetrics and Gynecology, Soroka University Medical Center, School of Medicine, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
authors.forename: Elad
authors.initials: E
authors.lastname: Leron
authors.affiliation: Department of Obstetrics and Gynecology, Soroka University Medical Center, School of Medicine, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
authors.forename: Eric
authors.initials: E
authors.lastname: Ohana
authors.affiliation: Department of Obstetrics and Gynecology, Soroka University Medical Center, School of Medicine, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
authors.forename: Mihai
authors.initials: M
authors.lastname: Meirovitz
authors.affiliation: Department of Obstetrics and Gynecology, Soroka University Medical Center, School of Medicine, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
authors.forename: Reli
authors.initials: R
authors.lastname: Hershkovitz
authors.affiliation: Department of Obstetrics and Gynecology, Soroka University Medical Center, School of Medicine, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
authors.forename: Offer
authors.initials: O
authors.lastname: Erez
keywords: cesarean section scar; dilatation and curettage; laparoscopy; placenta percreta; residua; spontaneous uterine rupture; uterine injury