TITLE:
Placenta Percreta Causing Rupture of Uterus in Second Trimester of Pregnancy in Non Scarred Uterus with an Unusual Presentation: A Case Report and Review of Literature
AUTHORS:
Reena Pal, Deepmala Prasad, Suchitra Jain
KEYWORDS:
Placenta Percreta, Spontaneous Uterine Rupture, Second Trimester, Non Scarred Uterus
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.4 No.11,
August
28,
2014
ABSTRACT: Placenta percreta causing
second trimester, spontaneous uterine rupture in non high risk women is less
frequent and fewer cases have been reported in the literature. We report a case
of uterine rupture in second trimester of pregnancy due to placenta percreta
with non specific symptoms in otherwise uncomplicated pregnancy without any
high risk factors. This case report describes the case of young woman
presenting second gravid with 21 weeks pregnancy with complaints of whole
abdomen pain and dysuria. Ultrasonography shows single intrauterine dead fetus;
placenta was fundoposterior in upper segment, a hypoechoic area seen below the
placenta suggestive of abruption placentae or placenta accreta. Suddenly
patient deteriorated in two hours of hospital stay, frank hemoperitoneum
detected, emergency laparotomy done, per operatively whole fundal area of
uterus became papery thin and cystic on touch, a small rent seen on fundal
surface of uterus. The placenta was densely adhered to the fundoposterior
aspect of the uterus. Patient had emergency subtotal hysterectomy. This case
highlights that placenta percreta is a rare but serious complication of
pregnancy which may present in early pregnancy without any associated high risk
factors for placenta percreta with unusual symptoms.