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Hum. Reprod. Advance Access published online on August 6, 2004
Human Reproduction, doi:10.1093/humrep/deh421
© 2004 by European Society of Human Reproduction and Embryology
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Received January 20, 2004
Revised May 13, 2004
Accepted June 24, 2004

Case report

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

A. Esmans 1, J. Gerris 1*, E. Corthout 1, P. Verdonk 1, S. Declercq 2

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

* To whom correspondence should be addressed. E-mail: jan.gerris{at}zna.be.


  Abstract

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.

Keywords: hysterectomy; placenta percreta; spontaneous uterus rupture.
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