Placenta percreta with silent rupture of the uterus

Abstract

We report a case of placenta percreta diagnosed by ultrasound and color doppler image at the fourteenth week of gestation. Initial approach was a trial of 1Mmethotrexate followed by total hysterectomy, during which was observed a rupture of the uterus with the adherence of the placenta to the posterior region of the bladder. We also present a literature review on the incidence ()~placenta percreta, etiology, diagnosis, treatment, and complications.UNITERMS: Placenta accreta. Rupture of the uterus.

Placenta acreta en el primer trimestre de la gestación: presentación de dos casos y revisión de la literatura

“…En Brasil reportaron un caso de placenta percreta diagnosticada por ultrasonido y Doppler color en la semana catorce de gestación; en este caso se realizó un manejo inicial fallido con metrotexate IM, seguido por histerectomía total, durante la cual se observó ruptura del útero, con infiltración de la placenta a la pared posterior de la vejiga. (Passini Junior R, 1996).…”

Spontaneous combined bladder and uterine rupture in pregnancy

“…Spontaneous uterine rupture has been associated with placental invasion, previous uterine surgery, congenital abnormalities of the uterus and coitus 4 . Where uterine rupture involved the bladder, only one case was unassociated with surgical termination of pregnancy 5 . Unusual presenting symptomatology of combined uterine and bladder rupture include vernix caseosa in maternal urine and meconium‐stained urine 6 .…”