Spontaneous Uterine Rupture at The 13th Weeks of Gestation Caused by Placenta Percreata: A Case Report

Abstract

To describe the management of a ruptured uterus caused by placenta percreta at the 13th week of gestation. Spontaneous rupture of the nonlaboring uterus is a relatively rare occurrence in obstetrics. It is associated with massive intra-peritoneal bleeding which can be mortal if not recognized. A 33-year-old patient presented with severe abdominal pain at the 13th week of gestation at the emergency service of Health Sciences University Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey. The patient’s ultrasonography revealed free fluid in the abdomen, placenta previa and anomaly in the fetus. Magnetic resonance imaging (MRI) was performed for differential diagnosis of free fluid. MRI showed hematoma between the bladder and uterus.After the signs of hypovolemic shock developed, we performed an immediate laparotomy and a ruptured uterus was detected. The fetus was removed and a hysterectomy was performed. Pathology results showed placenta percreta. After a few days in hospital and transfusion of 5 liters of blood, the patient was discharged in a healthy condition. In a pregnant woman with severe abdominal pain, even in the 13th week of gestation, a placenta acreta has to be considered as a differential diagnosis. If there is no benefit of the other treatments, hysterectomy is a life-saving intervention.

Keywords

• Placenta Percreta
• Uterine Rupture
• Pregnancy

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