Hysterectomy with Fetus In Situ for Uterine Rupture at 21-Week Gestation due to a Morbidly Adherent Placenta

BACKGROUND: Uterine rupture due to a morbidly adherent placenta is a rare obstetrical cause of acute abdominal pain in the pregnant patient. We present a case to add to the small body of published literature describing this diagnosis. CASE: A 32-year-old G5T2P1A1L2 with multiple prior cesarean secti...

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Detalles Bibliográficos
Autores principales: Pizzuto, Katerina, Ozimok, Cory, Bozanovic, Radenka, Tafler, Kathleen, Scattolon, Sarah, Leyland, Nicholas A., Morais, Michelle
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2018
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6139238/
https://www.ncbi.nlm.nih.gov/pubmed/30245897
http://dx.doi.org/10.1155/2018/5430591
Descripción
Sumario:BACKGROUND: Uterine rupture due to a morbidly adherent placenta is a rare obstetrical cause of acute abdominal pain in the pregnant patient. We present a case to add to the small body of published literature describing this diagnosis. CASE: A 32-year-old G5T2P1A1L2 with multiple prior cesarean sections presented at 21(+3) weeks' gestation with abdominal pain and presyncope. Ultrasound showed a large volume of complex intraabdominal free fluid and a heterogenous placenta with irregular lacunae and increased vascularity extending to the posterior bladder wall. Exploratory laparotomy identified a uterine defect and a hysterectomy was performed due to significant bleeding. Pathology confirmed a diagnosis of placenta percreta. CONCLUSION: Early recognition and management of uterine rupture due to a morbidly adherent placenta are essential to prevent catastrophic hemorrhage.

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