Haemoperitoneum due to placenta percreta in the third trimester mimicking placental abruption

Placental Abruption Revealed by Hemoperitoneum: A Case Report

“…6,7 The literature also includes cases involving rupture of a uterine artery aneurysm 8 or an unscarred uterus, 9 especially in women with endometriosis 10 or placentation abnormalities (such as placenta percreta). 11,12 In this case report, the context and clinical picture at admission did not suggest placental abruption. Only the ultrasound examination revealed the presence of an intrauterine hematoma, and nothing about its appearance suggested placental abruption.…”

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

“…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].…”

“…Placenta percreta has also been reported to occur without any known predisposing factors [8,9]. The diagnosis can often be missed due to preference for diagnosing more common causes of abdominal pain and anaemia in pregnancy such as concealed abruptio placentae as reported in the index case and case reported by Vyjayanthi and colleagues [7]. Delay in diagnosing the cause may lead to increased maternal and fetal morbidity and even mortality.…”

“…Management of placenta percreta causing uterine rupture depends on the clinical scenario. 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].…”

Hemoperitoneum in a patient with spontaneous rupture of the posterior wall of an unscarred uterus in the second trimester of pregnancy

“…Placental abruption is not a cause of hemoperitoneum in the absence of uterine rupture. However, during pregnancy, the clinical features of hemoperitoneum can trigger a suspicion of placental abruption because these conditions share similar clinical features, and these similarities can cause diagnostic difficulties [ 12 ]. Uterine anomalies are a reported cause of rupture of the unscarred uterus in the first trimester in patients with uterine anomalies [ 13 ].…”