Spontaneous uterine rupture due to placenta percreta during pregnancy

Sun, Jiankun; Zhang, Bao Long; Hai, Yu; Zhang, Qiang

doi:10.1016/j.ajem.2016.02.015

Cited by 9 publications

(8 citation statements)

References 13 publications

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“…When uterine rupture does present during early trimesters it is most often seen in women with a scarred uterus secondary to prior surgeries involving the uterus or with underlying physiologic defects such as placenta precreta. In these instances, patients can have defects of the myometrium and endometrium compromising the uterus’ anatomic structural integrity [7].…”

Section: Discussionmentioning

confidence: 99%

Atypical presentation of hemorrhagic shock in pregnancy: a case highlighting the developing field of emergency medicine in Israel

et al. 2019

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Background: Occult hemorrhagic shock secondary to uterine rupture represents a true obstetric emergency and can result in significant morbidity and mortality for both the patient and the fetus. Multiparity and prior cesarean sections are known risk factors. Typically, these patients present late in gestation, often secondary to the physiologic stresses on the uterus related to contractions. This pathology is less common earlier in pregnancy and can often be overlooked in the acute setting. Case presentation: We present the case of a 31-year-old female with three prior gestations, two parities and two prior cesarean sections, resulting in three live births, who presented to the Emergency Department (ED) 22-weeks pregnant with acute onset dyspnea and an episode of syncope. Due to her altered mental status there was concern for occult shock, despite normal vital signs. Large amounts of free fluid in the abdomen were noted on bedside ultrasonography with a high suspicion for uterine pathology. She was resuscitated with blood and taken immediately to the operating room for surgical management where she was found to have had a uterine rupture. Conclusion: This case highlights a rare presentation of a well-known obstetric emergency, due to the patient's development of uterine rupture early in gestation. Consequently, emergency physicians should consider atraumatic hypovolemic shock, secondary to this obstetric catastrophe, even at a stage that far precedes its expected presentation. In addition, we make note of how this case validated our department's integrated emergency medicine model, the first in the State of Israel.

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Section: Discussionmentioning

confidence: 99%

Atypical presentation of hemorrhagic shock in pregnancy: a case highlighting the developing field of emergency medicine in Israel

et al. 2019

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“…Overall, women with accreta placentation should be cared for according to the risks of severe maternal bleeding and premature delivery. Placenta percreta can be associated with major prenatal complications from early in pregnancy, such as uterine rupture [150][151][152] and bladder involvement with associated life-threatening haemorrhage. [153][154][155] A 2015 expert review has suggested that caesarean delivery of women at high risk and/or diagnosed prenatally with placenta accreta spectrum, in particular its invasive forms, should occur in a specialist centre with multidisciplinary expertise and experience in managing complex pelvic surgery, and with access to an adult intensive care unit and NICU.…”

Section: [New 2018]mentioning

confidence: 99%

Placenta Praevia and Placenta Accreta: Diagnosis and Management

Jauniaux¹,

Alfirević²,

Bhide³

et al. 2018

BJOG

424

415

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“…El dolor abdominal es debido a irritación por sangre intraperitoneal; irradiado a los hombros debido a la irritación sub-diafragmática. [12,[16][17][18][19][20][21]. La hipotensión materna junto con taquicardia, así como signos de pérdida de bienestar fetal o muerte fetal, son signos indicativos de rotura uterina, siendo necesario para el diagnóstico un alto grado de sospecha, incluso con factores de riesgo presentes.…”

Section: Presentación Del Casounclassified

“…[20,[22][23][24][25][26] La mayoría utilizamos la ecografía como método diagnostico principal visualizando líquido libre. Por otra parte, las imágenes por ultrasonido asociado a Doppler color, podrían ser capaces de identificar anomalías en adhesión y de invasión de la placenta en el miometrio y órganos adyacentes como vejiga.…”

Section: Presentación Del Casounclassified