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Hum. Reprod. Advance Access originally published online on August 6, 2004
Human Reproduction 2004 19(10):2401-2403; doi:10.1093/humrep/deh421
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Human Reproduction vol. 19 no. 10 © European Society of Human Reproduction and Embryology 2004; all rights reserved

Placenta percreta causing rupture of an unscarred uterus at the end of the first trimester of pregnancy: Case report

A. Esmans1, J. Gerris1,3, E. Corthout1, P. Verdonk1 and S. Declercq2

1 Department of Obstetrics and Gynecology and 2 Department of Pathology, Lindendreef 1, 2020 Antwerp, Belgium

3 To whom correspondence should be addressed. Email: jan.gerris{at}zna.be

Reports on placenta percreta in early pregnancy leading to a spontaneous rupture of the uterus are rare. We report a case of this potentially life-threatening complication in the 14th week of pregnancy in an otherwise healthy woman who underwent a manual extraction of the placenta during a previous delivery but who had no history of severe pathology that could have potentially resulted in uterine damage. The occurrence of severe abdominal pain and the presence of a large quantity of free fluid in the abdomen necessitated an emergency laparotomy, revealing a haemoperitoneum due to rupture of the uterus, which was followed by a hysterectomy. This case demonstrates that in patients with a history of placenta accreta and subsequent manual extraction of the placenta, a close investigation of the uterine wall and placentation should be performed in the first trimester in order to anticipate a placenta percreta.

Key words: hysterectomy/placenta percreta/spontaneous uterus rupture


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