Placenta percreta and uterine rupture at 16 weeks

Abstract

Placenta percreta is a complication of pregnancy with significant morbidity and mortality rates. Spontaneous uterine rupture in early pregnancy due to placenta percreta is rare. We report a case of this life-threatening complication occurring at the sixteenth week of gestation. The patient presented with signs of shock, acute abdomen, and evidence of hemoperitoneum. The pregnancy was viable with a normal ultrasound appearance that created some confusion and there was a dilemma in the diagnosis of this case. Various obstetric and surgical causes were taken into consideration. The patient was taken to the operating room immediately for exploratory laparotomy. She was found to have fundal uterine rupture, which was managed by uterine repair. This patient had prior cesarean section and dilatation and curettage; factors well known to predispose for placenta percreta. Here, we emphasize the importance of a fast decision and surgical intervention to save a patient's life in cases of uterine rupture.