Placenta percreta with spontaneous rupture of an unscarred uterus in the second trimester

LeMaire, William J.; Louisy, Claire; Dalessandri, Kathie M.; Muschenheim, Frederick

doi:10.1016/s0029-7844(01)01580-0

Cited by 39 publications

(27 citation statements)

References 5 publications

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“…Patient 2 ' s request for termination of pregnancy was accepted by the Ethics Committee, in light of the extensive placental infi ltration, which was likely to deteriorate further with advancing pregnancy. Notably, several cases of uterine rupture and massive hemorrhaging have been reported for placenta percreta diagnosed at the beginning of the second trimester [3,12,14] .…”

Section: Discussionmentioning

confidence: 99%

Individual decisions in placenta increta and percreta: a case series

Chantraine

Nisolle

Petit

et al. 2012

Jpme

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Objective: Placenta increta or percreta is an uncommon pathology, sometimes associated with high maternal morbidity. Its prevalence increases proportionally to the number of cesarean sections. This study analyzed the changes of our management strategy to devise treatment guidelines for this uncommon disorder. Materials and methodology: Between 2005 and 2011, 10 cases of placenta increta or percreta were managed at our university hospital maternity department. Results: Among the 10 cases, seven were diagnosed prenatally. Two patients were diagnosed early, at 14 and 17 weeks of gestational age, and their pregnancies were terminated. Five had hysterectomies during the intrapartum period, and despite attempted conservative treatment for the two others, hysterectomy proved necessary 2 months postpartum because of intrauterine infections. Seven of the 10 women had hysterectomies. Conclusion: Prenatal diagnosis of placenta increta or percreta is essential to plan the delivery in a competent tertiary care center. The decision to perform a cesarean hysterectomy or leave the placenta in situ for spontaneous delivery is based on the extent of infi ltration, the patient ' s hemodynamic status, and her desire to remain fertile. The high-risk of infection and severe hemorrhage must not be overlooked should conservative treatment be chosen. This situation requires prolonged close monitoring.

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Section: Discussionmentioning

confidence: 99%

Individual decisions in placenta increta and percreta: a case series

Chantraine

Nisolle

Petit

et al. 2012

Jpme

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“…After previous cesarean section, the incidence varies between 0.4% and 0.9% [3,5] whereas in women without prior uterine surgery the incidence of uterine rupture is about 0.006%-0.02% [4,5]. In addition to previous cesarean section, postulated risk factors for uterine rupture are induction of labor, maternal age, multiparity, gestational age at delivery, vacuum-assisted birth, fetal birth weight, short inter pregnancy interval, prolonged second stage of labor, abnormal placentation, and uterine fundal pressure (UFP) [2,[6][7][8][9][10][11][12][13][14][15]. Although UFP is widely used [16] -a survey in the US found that in 80% of institutions UFP was applied [17] -there is scarce data about its' association with uterine rupture [16,17].…”

Section: Introductionmentioning

confidence: 99%

Risk factors of uterine rupture with a special interest to uterine fundal pressure

Sturzenegger

Schäffer

Zimmermann

et al. 2017

Journal of Perinatal Medicine

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PURPOSE Uterine rupture is a rare but serious event with a median incidence of 0.09%. Previous uterine surgery is the most common risk factor. The aim of our study was to analyze retrospectively women with uterine rupture during labor and to evaluate postulated risk factors such as uterine fundal pressure (UFP). METHODS Twenty thousand one hundred and fifty-two deliveries were analyzed retrospectively. Inclusion criteria were 22 weeks and 0 days-42 weeks and 0 days of gestation, singleton pregnancy and cephalic presentation. Women with primary cesarean section were excluded. A logistic regression analysis adjusting for possible risk factors was conducted and a subgroup analysis of women with unscarred uterus was performed. RESULTS Twenty-eight cases of uterine rupture were identified (incidence: 0.14%). Uterine rupture was noticed in multipara patients only. In the multivariate analysis among all study patients, only previous cesarean section remained a statistically significant risk factor [adjusted odds ration (adj. OR) 12.52 confidence interval (CI) 95% 5.21-30.09]. In the subgroup analysis among women with unscarred uterus (n=19,415) three risk factors were associated with uterine rupture: UFP (adj. OR 5.22 CI 95% 1.07-25.55), abnormal placentation (adj. OR 20.82 CI 95% 2.48-175.16) and age at delivery >40 years (adj. OR 4.77 CI 95% 1.44-15.85). CONCLUSIONS The main risk factor for uterine rupture in the whole study population is previous uterine surgery. Risk factors in women with unscarred uterus were UFP, abnormal placentation, and age at delivery >40 years. The only factor which can be modified is UFP. We suggest that UFP should be used with caution at least in presence of other supposed risk factors. AbstractPurpose: Uterine rupture is a rare but serious event with a median incidence of 0.09%. Previous uterine surgery is the most common risk factor. The aim of our study was to analyze retrospectively women with uterine rupture during labor and to evaluate postulated risk factors such as uterine fundal pressure (UFP). Methods: Twenty thousand one hundred and fifty-two deliveries were analyzed retrospectively. Inclusion criteria were 22 weeks and 0 days-42 weeks and 0 days of gestation, singleton pregnancy and cephalic presentation. Women with primary cesarean section were excluded. A logistic regression analysis adjusting for possible risk factors was conducted and a subgroup analysis of women with unscarred uterus was performed. Results: Twenty-eight cases of uterine rupture were identified (incidence: 0.14%). Uterine rupture was noticed in multipara patients only. In the multivariate analysis among all study patients, only previous cesarean section remained a statistically significant risk factor [adjusted odds ration (adj. OR) 12.52 confidence interval (CI) 95% 5.21-30.09]. In the subgroup analysis among women with unscarred uterus (n = 19,415) three risk factors were associated with uterine rupture: UFP (adj. OR 5.22 CI 95% 1.07-25.55), abnormal placentation ) and age at delivery > 40 year...

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“…8,9 The patient in this case report had no symptoms as discussed earlier except for ployhydramnios on presentation but later she developed antepartum hemorrhage and gross hematuria.…”

Section: Discussionmentioning

confidence: 58%

Central placenta previa with placenta percreta partially invading bladder: a case report

Banu

Hui

et al. 2015

Int J Reprod Contracept Obstet Gynecol

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Placenta percreta with spontaneous rupture of an unscarred uterus in the second trimester

Abstract: Spontaneous rupture of an unscarred uterus, due to placenta percreta, should be considered in cases of acute intraperitoneal hemorrhage, even in early pregnancy.

Cited by 39 publications

References 5 publications

Individual decisions in placenta increta and percreta: a case series

Individual decisions in placenta increta and percreta: a case series

Risk factors of uterine rupture with a special interest to uterine fundal pressure

Central placenta previa with placenta percreta partially invading bladder: a case report

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