Uterine rupture with massive hemoperitoneum due to placenta percreta in a second trimester: A case report

INTRODUCTION: Uterine rupture due to placenta percreta is very rare. It often occurs in patients with a history of Cesarean section. Quick diagnosis, management and intervention improves survival rate and decreases maternal and foetal morbidity. OBSERVATION: Patient, 36 years old, mother of three children delivered by cesarean section, admitted for acute abdominal pain in the context of a poorly monitored pregnancy estimated at 25 weeks of amenorrhea. Pelvic ultrasound showed a large peritoneal effusion with the presence of an evolving intrauterine pregnancy with cardiac activity present, the placenta was with anterior coverage. An emergency laparotomy revealed uterine rupture with active hemorrhage localized on the anterior uterine scar with placental protrusion was noted. A cesarean section was quickly performed to save the fetus. The placenta was left in place and a difficult hysterectomy was then undertaken. DISCUSSION: Uterine rupture in second trimester caused by placental percreta is a rare event that can be life threatening for both mother and fetus. Placenta percreta should be considered when diagnosing internal bleeding in a patient during the first trimester of pregnancy. CONCLUSION: Placenta percreta is a rare but severe obstetric complication that is potentially life threatening for both the mother and fetus. It is important to maintain a high level of clinical suspicion for this disease in pregnant women with acute abdomen, especially those with specific risk factors.