Placenta Percreta Leading to Spontaneous Complete Uterine Rupture in the Second Trimester

Abstract

A 30-year-old gravida 2 para 1 was admitted to hospital 2 years after cesarean section at 20 weeks’ gestation with acute onset of abdominal pain and hypovolaemic shock. Emergency laparotomy revealed a uterine rupture located in the anterior uterine wall caused by a placenta percreta and supracervical hysterectomy was performed. This site of invasion and finally rupture was in projection of the previous lower-segment cesarean section. This report illustrates the dramatic consequences of abnormal placentation after prior uterine surgery, which can already occur early during pregnancy and prior to the onset of labour.

Placenta Accreta at 15 Weeks of Gestational Age and Uterus Preservation with Hysterectomy Abortion

“…While rupture of uterus in placenta accreta during early pregnancy is happened, hysterectomy because of hemoperitoneum and hypovolemic shock is necessary. In Japan, Turkey, Mexico, and Germany have reported a few cases with uterine rupture in placenta accrete [5][6][7][8][9]. All these patients underwent hysterectomy.…”

Placenta Percreta at 17 Weeks with Consecutive Hysterectomy: A Case Report and Review of the Literature

“…A few such cases of spontaneous rupture of uterus due to placenta percreta have been reported in countries other than USA, like Japan, Turkey, Mexico, and Germany [10–14]. All these cases noted either previous cesarean deliveries or curettages in their patients, with the exception of Kinoshita et al from Japan, who reported a case of spontaneous rupture of uterus due to placenta percreta in the patient's first pregnancy without a background of any risk factors [12].…”

Rotura uterina durante el segundo trimestre de gestación asociado a placenta percreta: presentación de un caso y revisión de la literature

“…El diagnostico se debe sospechar por los hallazgos al examen físico como hipotensión arterial, taquicardia, distensión abdominal, anemizacion aguda sin causa aparente, lo que define inestabilidad hemodinámica, la historia clínica y antecedentes quirúrgicos deben ser tenidos en cuenta. [10][11][12][13][14][15][16][17]Tabla 5. El dolor abdominal es debido a irritación por sangre intraperitoneal; irradiado a los hombros debido a la irritación sub-diafragmática.…”

“…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.…”