Kosin Med J.  2017 Dec;32(2):263-268. 10.7180/kmj.2017.32.2.263.

Spontaneous uterine rupture due to placenta percreta in the second trimester of pregnancy: a case report

• Seo SY
• Kim DW
• Kim BM
• Chun SW

• KMID: 2400272
• DOI: http://doi.org/10.7180/kmj.2017.32.2.263

Abstract

A 32-year-old multiparous woman (gravida 2, para 2) with a history of previous cesarean section had acute abdominal pain and collapsed at 21 weeks of gestation. Exploratory laparotomy was performed because of the patient's worsening condition; ultrasound examination results were suggestive of massive hemoperitoneum, and fetus in vertex presentation with bradycardia. Uterine rupture between the left lower segment and borderline of the cervix in the anterior wall with active bleeding was confirmed. An uncomplicated classical cesarean section was performed, but the fetus was stillborn due to preterm birth. Hysterectomy was performed after the cesarean section. The patient was admitted to intensive care units for 3 days and was discharged in 12 days following delivery. Placenta percreta at the anterior lower segment of the uterus was confirmed in the pathology report.

Keyword

Hemoperitoneum; Hysterectomy; Placenta percreta; Uterine rupture

MeSH Terms

Abdominal Pain
Adult
Bradycardia
Cervix Uteri
Cesarean Section
Female
Fetus
Hemoperitoneum
Hemorrhage
Humans
Hysterectomy
Intensive Care Units
Laparotomy
Pathology
Placenta Accreta*
Placenta*
Pregnancy
Pregnancy Trimester, Second*
Pregnancy*
Premature Birth
Ultrasonography
Uterine Rupture*
Uterus

Figure

• 

  Fig. 1 Gross findings of the specimen. Hysterectomy speciment was separated because of uterine perforation. On gross examination, no placenta was found to be growing through the uterine wall.

• 

  Fig. 2 Fig. 2A. Histologic findings from the resected specimen (H&E, × 200). Invasive intermediate trophoblasts penetrated the myometrium through the superficial and deep portion. Fig. 2B. (H&E, × 200). In the perforation site near serosal side, there was a floating well developed villus admixed with fibrin material.

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