Placenta Percreta Masquerading as an Acute Abdomen

Roca, Luis E; Hoffman, M. Camille; Gaitan, Lucia; Burkett, Gene

doi:10.1097/aog.0b013e318188bece

Cited by 8 publications

(4 citation statements)

References 6 publications

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“…One study by Zhang Y, Zhao Y, in 2009 showed spontaneous intra-abdominal bleeding in the third trimester of pregnancy due to a lesion resulting from endometriosis and chronic pelvic inflammatory disease 12 . Other reported causes were placenta percreta 13 , spontaneous rupture of uterine vessels 14,15 , spontaneous rupture of varicose veins on the surface of the uterus 16 spontaneous rupture of a previously unknown scarred uterus 17 or could be idiopathic 18 .…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Rupture of Subserous Uterine Vein in Late Pregnancy

Yasmin

Kabir

Ferdous

2016

Bangladesh J Obstet Gynaecol

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Objective: Premature uterine contraction caused by spontaneous rupture of subserous uterine vein resulting intrauterine asphyxia.Method & Results: A primigravida with uneventful pregnancy having regular antenatal care attended a private clinic at her 38 week of pregnancy with slight pain in whole abdomen and hardening of uterus. After giving rest in left lateral position & oxygen inhalation, hardening of uterus persisted. By that time she developed fetal tachycardia and had to undergo caesarean section, there was hemoperitonum and an asphyxiated male baby was delivered. On exploration a subserous uterine vein was detected on the posterior wall of the uterus. Complete hemostasis was achieved with interrupted sutures and electrocauterization of the bleeding points. Post-operative period was uneventful for the mother but the baby was managed in neonatal care unit. Both of them were well during discharge.Conclusion: Monitoring of pregnant women at last trimester is very important. Any deviation from normal like hardening of uterus should be carefully taken care of for good maternal and fetal outcome.Bangladesh J Obstet Gynaecol, 2012; Vol. 27(2) : 87-89

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Section: Discussionmentioning

confidence: 99%

Spontaneous Rupture of Subserous Uterine Vein in Late Pregnancy

Yasmin

Kabir

Ferdous

2016

Bangladesh J Obstet Gynaecol

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“…Anterior placenta praevia in a woman with a previous caesarean section scar increases the risk of morbidly adherent placenta (placenta accreta, increta and percreta) and may result in postpartum haemorrhage. Recently, placenta percreta presenting with an acute abdomen and massive haemoperitoneum in the antepartum period has been reported [14].…”

Section: Management Of Placenta Praeviamentioning

confidence: 99%

Management of Massive Obstetric Haemorrhage

Krishna¹,

Chandraharan²

2011

CWHR

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Obstetric haemorrhage refers to any bleeding that occurs during pregnancy, delivery or in the postpartum period. It is associated with maternal morbidity and remains the leading cause of direct maternal deaths in developing countries. Antepartum haemorrhage (APH) refers to any genital tract bleeding prior to the delivery of the baby. Identifiable causes of APH include placenta praevia, placental abruption, vasa praevia and local organic pathology such as genital tract tumours. The exact cause of APH remains uncertain in approximately 50% of patients. Postpartum haemorrhage (PPH) refers to excessive bleeding from the genital tract after the delivery of the baby and is termed primary when it occurs within the first 24 hours of birth. Common causes include atonic uterus, genital tract trauma, retained placental tissue and coagulopathy. Secondary PPH occurs after the first 24 hours and is due to retained products of conception and/or infection (endometritis). The management algorithm 'HAEMOSTASIS' has been proposed to aid the systematic management of postpartum haemorrhage.A multidisciplinary approach is essential to improve outcomes. Early diagnosis, timely institution of appropriate measures to arrest haemorrhage, replacement of blood volume (intravenous fluids), ensuring oxygen carrying capacity of blood (by blood transfusion) and correction of coagulopathy may help save lives.

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“…Although early diagnosis of PAS is desirable to avoid associated adverse outcome [8][9][10][11][12][13][14][15] , it is challenging, and the diagnosis is often missed even in high-risk populations 16 . Among women with anterior placenta previa and previous CS, 1 in 3 is at risk of PAS 17 .…”

Section: Introductionmentioning

confidence: 99%

Lower uterine segment scar assessment at 11–14 weeks' gestation to screen for placenta accreta spectrum in women with prior Cesarean delivery

Bhatia

Palacio

Wright

et al. 2022

Ultrasound in Obstet & Gyne

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What are the novel findings of this work?In pregnant women with previous Cesarean section, assessment of the lower uterine segment scar on transvaginal ultrasound at the time of first-trimester aneuploidy screening is accurate and feasible. This screening strategy can identify reliably women at high risk of subsequent development of placenta accreta spectrum disorder. What are the clinical implications of this work?Routine first-trimester assessment of the location of the lower uterine segment scar in women with prior Cesarean section may become part of early risk assessment for placenta accreta spectrum disorder. Implementation of such a scanning protocol should help plan optimal multidisciplinary management of high-risk pregnancies while reassuring the vast majority of women with previous Cesarean section.

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Placenta Percreta Masquerading as an Acute Abdomen

Abstract: The presentation of an acute abdomen with symptoms remote from the site of pathology in the third trimester masked the diagnosis of placenta accreta. When a clear diagnosis cannot be established, operative exploration must be considered.

Cited by 8 publications

References 6 publications

Spontaneous Rupture of Subserous Uterine Vein in Late Pregnancy

Spontaneous Rupture of Subserous Uterine Vein in Late Pregnancy

Management of Massive Obstetric Haemorrhage

Lower uterine segment scar assessment at 11–14 weeks' gestation to screen for placenta accreta spectrum in women with prior Cesarean delivery

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