Shahida Akhtar.
Placenta Percreta with painless uterine rupture at the 2nd trimester.
Pak Armed Forces Med J Jun 2003;53(1):99-100.
Combined Military Hospital, Rawalpindi

A 37-year old lady was admitted to the hospital at 25 weeks and 3 days gestation with slight vaginal bleeding. She was para 7+0. Her 6th delivery was by LSCS followed by a normal vaginal delivery. She had no other significant current past medical history. An ultrasound (US) revealed a placenta previa (Type IV). She remained stable in the hospital, with slight on and off vaginal bleeding and no abdominal pain Her investigation were normal Four units of blood were cross matched and kept in reserve. At 27 weeks and 2 days gestation. She complained of sudden painless heavy vaginal bleeding. The loss was estimated to be around one litre. The abdomen was soft, not tender and fundal size corresponded to gestational age. The fetal heart sounds were regular. The patient was taken urgently to the theatre, resuscitation commenced efficiently with blood transfusion and laparotomy was performed. There was no hemoperitoneum, a uterine rupture of approximately 3 cm was noted at the middle of the scar and the placenta was clearly seen through it, invading the uterine wall. The urinary bladder was intact. Dissection of the bladder was performed, followed by delivery of a baby weighing I 100gram, with Apgar score of 6 and 9 at one and 5 minutes. The placenta was very adherent and profuse bleeding started. An emergency hysterectomy was performed. The patient received 5 units of blood in the theatre. Her postoperative period was otherwise uneventful. The histopathology showed placenta percreta.

Category: Case Reports
Keywords: Placenta Percreta. Placenta. Uterus. Uterine Rupture. Pregnancy.

Click here for Full Text Article

This article has been viewed 509 times

Submit your Research Synopsis for Free Expert analysis - Search- Feedback - Drug Index
Post and View Comments on this Article