An undiagnosed case of placenta percreta presenting as a massive hemoperitoneum in obstetric emergency

Abstract

Abstract

Placenta percreta causing spontaneous uterine rupture and intrauterine fetal death in an unscared uterus: A case report

“…Placenta percreta is an unusual cause of uterine rupture and subsequent antepartum haemorrhage. It has been documented to cause uterine rupture in any trimester [[1], [2], [3]]. As previously reported by Khandaker [1], the index patient had uterine rupture in the third trimester.…”

“…Risk factors for the occurrence of placenta percreta include previous uterine surgeries (caesarean delivery, myomectomy and metroplasty) [1,2], dilatation and curettage for abortion and previous history of manual removal of placenta [7]. Also, whole body radiation therapy for medical conditions like childhood leukemias has been reported as an uncommon cause of placenta percreta [3].…”

“…Most cases of placenta percreta causing uterine rupture in the third trimester usually result in perinatal mortality. However, in cases where early diagnosis is made and there is mild haemorrhage, fetal salvage may be possible [1].…”

“…If the entire placenta is morbidly adherent, hysterectomy should be performed [2,3,7,9]. However, if the placenta can be delivered easily, the rent on the uterus can be repaired as was done in the index patient and in the case reported by Khandaker [1]. Laparoscopic repair of the rent in stable cases has been attempted in the second trimester, however in that case report, eventual hysterectomy was performed when evacuation of the products of conception failed [10].…”

“…It is a life-threatening condition for both the mother and the fetus. Placenta percreta has the potential to cause adverse events that could occur in the antepartum, intrapartum and postpartum periods [1,2]. One of these rare adverse events is uterine rupture which is an obstetric catastrophe with high maternal and perinatal morbidity/mortality [[1], [2], [3]].…”