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Chorioangioma is the most common non trophoblastic tumor of the placenta which can result in pregnancy complications with attendant maternal and fetal mortality and morbidity.Although majority of them are asymptomatic, clinical course depends mainly on the size of the neoplasm.We present a case of  large symptomatic placental chorioangioma managed successfully at Shri B M Patil Medical College,Vijayapura.The patient presented with acute features of abruptio placenta secondary to sudden decompression of uterus with polyhydramnios associated with large placental capillary chorioangioma of 10 cm size.Immediate intervention with Emergency LSCS helped rescue the baby of Intauterine demise and possible hemorrhagic morbidity in the mother.Further gross and histological examination confirmed the diagnosis.

Uterine rupture in pregnancy is a rare and often a catastrophic complication with a high risk of fetal and maternal morbidity and mortality. Uterine rupture associated with urinary bladder rupture is a rare but a challenging situation for a practicing obstetrician. A 29 year old 2 nd gravida with full term gestation with previous LSCS came with complaints of labor pains and P/V leak of 12 hours. There were features suggestive of rupture uterus with simultaneous bladder rupture. A diagnosis of G2P1D1 with term gestation with previous LSCS with rupture uterus with rupture bladder with intrauterine fetal death was made. There was rupture of the previous scar with extension to the anterior vaginal wall with rupture of the posterior wall of the bladder. Uterine and bladder rupture were repaired and peritoneal flap interposed between them and hence conservatively managed. Bladder rupture may be associated with uterine rupture during attempted vaginal birth after cesarean. The potential for bladder injury should be included in the patient's antepartum counseling. KEY WORDS: Rupture uterus, LSCS, labor, vaginal birth after cesarean, bladder rupture. INTRODUCTION:Uterine rupture in pregnancy is a rare and often a catastrophic complication with a high risk of fetal and maternal morbidity and mortality. Rupture of the uterus can occur in a scarred or an unscarred uterus. The risk of uterine rupture ranges from 0.5% to 9% depending upon the type and location of the previous uterine incision. Rupture of the uterus can also involve the other adjacent organs and the most common involvement being the urinary bladder. This being the most common obstetric emergency met in the developing countries.Here we report a case of 2 nd gravida with previous LSCS who presented with rupture uterus with simultaneous rupture of urinary bladder with intrauterine fetal death.

With rising incidence of caesarean sections and the number of cases of placenta praevia, incidence of morbidly adherent placenta is on the rise. Morbidly adherent placenta, which includes placenta accreta, Increta, and percreta, implies an abnormal implantation of the placenta into the uterine wall. Sonographic markers of placenta accreta can be present as early as the first trimester, such as low uterine implantation of a gestational sac, multiple vascular lacunae within the placenta, loss of the normal hypoechoic retroplacental zone and abnormality of the uterine serosa-bladder interface. Ultrasound has high sensitivity and specificity for the diagnosis of placenta accreta. MRI should be reserved for rare cases in which ultrasound is non-diagnostic. The successful management of placenta accreta includes a team approach with the successful management relying on the prenatal diagnosis of this entity and preparing for the surgical management. Antenatal diagnosis and management in a tertiary care centre helps to reduce maternal and neonatal morbidity and mortality. 1 We present a patient in whom the antenatal diagnosis of morbidly adherent placenta was missed due to lack of antenatal care and presented as second trimester spontaneous incomplete abortion.