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Perdue M, Felder L, Berghella V. First-trimester uterine rupture: a case report and systematic review of the literature. Am J Obstet Gynecol 2022; 227:209-217. [PMID: 35487324 DOI: 10.1016/j.ajog.2022.04.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/18/2022] [Accepted: 04/21/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVE This study aimed to present a case of first-trimester uterine rupture and perform a systematic review to identify common presentations, risk factors, and management strategies. DATA SOURCES Searches were performed in PubMed, Ovid, and Scopus using a combination of key words related to "uterine rupture," "first trimester," and "early pregnancy" from database inception to September 30, 2020. STUDY ELIGIBILITY CRITERIA English language descriptions of uterine rupture at ≤14 weeks of gestation were included, and cases involving pregnancy termination and ectopic pregnancy were excluded. METHODS Outcomes for the systematic review included maternal demographics, description of uterine rupture, and specifics of uterine rupture diagnosis and management. Data were extracted to custom-made reporting forms. Median values were calculated for continuous variables, and percentages were calculated for categorical variables. The risk of bias was assessed using the Joanna Briggs Institute critical appraisal checklist for case reports and case series. RESULTS Overall, 61 cases of first-trimester uterine rupture were identified, including our novel case. First-trimester uterine ruptures occurred at a median gestation of 11 weeks. Most patients (59/61 [97%]) had abdominal pain as a presenting symptom, and previous uterine surgery was prevalent (44/61 [62%]), usually low transverse cesarean delivery (32/61 [52%]). The diagnosis of uterine rupture was generally made after surgical exploration (37/61 [61%]), with rupture noted in the fundus in 26 of 61 cases (43%) and in the lower segment in 27 of 61 cases (44%). Primary repair of the defect was possible in 40 of 61 cases (66%), whereas hysterectomy was performed in 18 of 61 cases (30%). Continuing pregnancy was possible in 4 of 61 cases (7%). CONCLUSION Uterine rupture is an uncommon occurrence but should be considered in patients with an acute abdomen in early pregnancy, especially in women with previous uterine surgery. Surgical exploration is typically needed to confirm the diagnosis and for management. Hysterectomy is not always necessary; primary uterine repair is sufficient in more than two-thirds of the cases to achieve hemostasis. Continuing pregnancy, although uncommon, is also possible.
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Affiliation(s)
- Makenzie Perdue
- Department of Obstetrics and Gynecology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA
| | - Laura Felder
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA
| | - Vincenzo Berghella
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA.
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Adwan D, Taifour W, Bhsass R, Taifour D. Fundal partial placenta percreta complicated with postpartum hemoperitoneum: A case report. Int J Surg Case Rep 2021; 88:106482. [PMID: 34653894 PMCID: PMC8522481 DOI: 10.1016/j.ijscr.2021.106482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 09/30/2021] [Accepted: 10/03/2021] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION The fundus of the uterus is a rare location for abnormally invasive placenta compared with the common site of abnormally invasive placenta in the lower segment of the uterus. PRESENTATION OF CASE We report a case of a 38-year-old multipara woman who had a fundal partial placenta percreta with no prior cesarean sections, which presented as a retained placenta after preterm labor, and complicated with hemorrhagic shock due to postpartum hemoperitoneum, thus it was diagnosed after surgery and managed by subtotal hysterectomy. DISCUSSION We discuss the most common risk factors for abnormally invasive placenta and its diagnosis and management. We compare the possibility of leading to invasive placenta resulting from curettage trauma and cesarean delivery scars. CONCLUSION History of uterine surgical procedures without prior cesarean delivery must raise suspicion of abnormally invasive placenta regardless of its localization, especially when associates with preterm labor or retained placenta.
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Affiliation(s)
- Dema Adwan
- Damascus University, Gynecology and Obstetrics Hospital, Damascus, Syria
| | - Wessam Taifour
- Damascus University, Gynecology and Obstetrics Hospital, Damascus, Syria.
| | - Rafat Bhsass
- Faculty of Medicine, Damascus University, Damascus, Syria
| | - Danny Taifour
- Faculty of Medicine, Damascus University, Damascus, Syria
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Badr DA, Al Hassan J, Salem Wehbe G, Ramadan MK. Uterine body placenta accreta spectrum: A detailed literature review. Placenta 2020; 95:44-52. [PMID: 32452401 DOI: 10.1016/j.placenta.2020.04.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 04/14/2020] [Indexed: 12/14/2022]
Abstract
Placenta accreta spectrum (PAS) is a major obstetrical problem whose incidence is rising. Current guidelines recommend screening of all women with placenta previa and risk factors for PAS between 20 and 24 weeks. Risk factors, diagnosis, and management of previa PAS are well established, but an apparently normal location of the placenta does not exclude PAS. Literature data are scarce on uterine body PAS, which carries a high risk of maternal and neonatal adverse outcome, but is still easily missed on prenatal ultrasound. We conducted a comprehensive review to identify possible risk factors, clinical presentations, and diagnostic modalities of uterine PAS. A total of 133 cases were found during a 70-year period (1949-2019). The vast majority of them presented with signs of uterine rupture, even prior to the viability threshold of 24 weeks (up to 45%). Major risk factors included previous cesarean delivery, uterine curettage, uterine surgery, Asherman's syndrome, manual removal of the placenta, endometritis, high parity, young maternal age, in vitro fertilization, radiotherapy, uterine artery embolization, and uterine leiomyoma. Diagnosis was pre-symptomatic in only 3% of cases. Future studies should differentiate between previa PAS and uterine body PAS.
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Affiliation(s)
- Dominique A Badr
- Brugmann University Hospital, Université Libre de Bruxelles, Brussels, Belgium.
| | - Jihad Al Hassan
- Al-Zahraa Hospital University Medical Center, Lebanese University, Beirut, Lebanon
| | - Georges Salem Wehbe
- Brugmann University Hospital, Université Libre de Bruxelles, Brussels, Belgium
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First Trimester Uterine Rupture: A Case Report and Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082976. [PMID: 32344763 PMCID: PMC7215710 DOI: 10.3390/ijerph17082976] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 04/17/2020] [Accepted: 04/21/2020] [Indexed: 11/17/2022]
Abstract
The aim is to report a case of spontaneous uterine rupture in the first trimester of pregnancy and to review the literature on the topic. METHODS A literature search was performed using PubMed and Scopus. Relevant English articles were identified without any time or study limitations. The data were aggregated, and a summary statistic was calculated. RESULTS A 35-year-old gravida 5, para 2 was admitted at our department because of fainting and abdominal pain. The woman had a first-trimester twin pregnancy and a history of two previous cesarean sections (CSs). Suspecting a uterine rupture, an emergency laparotomy was performed. The two sacs were completely removed, and the uterine rupture site was closed with a double-layer suture. The patient was discharged from hospital four days later in good condition. On the basis of this experience, a total of 76 case reports were extracted from PubMed and included in the review. Fifty-three patients out of 76 (69.74%) underwent previous surgery on the uterus. Most women (67.92%) had a CS, and in this group a cesarean scar pregnancy (CSP) or a placenta accreta spectrum (PAS) disorder was found to be the etiology in 77.78% of cases. Furthermore, 35.85% of the women had hysterectomy after uterine rupture. Twenty-three patients out of 76 (30.26%) had an unscarred uterus. Of this group, most women presented a uterine anomaly (43.48%). Moreover, 17.39% of these women had a hysterectomy. CONCLUSION According to the literature, the current pandemic use of CS explains most cases of first-trimester uterine rupture.
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5
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Atypical presentation of hemorrhagic shock in pregnancy: a case highlighting the developing field of emergency medicine in Israel. BMC Emerg Med 2019; 19:70. [PMID: 31752688 PMCID: PMC6868723 DOI: 10.1186/s12873-019-0272-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 09/24/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Occult hemorrhagic shock secondary to uterine rupture represents a true obstetric emergency and can result in significant morbidity and mortality for both the patient and the fetus. Multiparity and prior cesarean sections are known risk factors. Typically, these patients present late in gestation, often secondary to the physiologic stresses on the uterus related to contractions. This pathology is less common earlier in pregnancy and can often be overlooked in the acute setting. CASE PRESENTATION We present the case of a 31-year-old female with three prior gestations, two parities and two prior cesarean sections, resulting in three live births, who presented to the Emergency Department (ED) 22-weeks pregnant with acute onset dyspnea and an episode of syncope. Due to her altered mental status there was concern for occult shock, despite normal vital signs. Large amounts of free fluid in the abdomen were noted on bedside ultrasonography with a high suspicion for uterine pathology. She was resuscitated with blood and taken immediately to the operating room for surgical management where she was found to have had a uterine rupture. CONCLUSION This case highlights a rare presentation of a well-known obstetric emergency, due to the patient's development of uterine rupture early in gestation. Consequently, emergency physicians should consider atraumatic hypovolemic shock, secondary to this obstetric catastrophe, even at a stage that far precedes its expected presentation. In addition, we make note of how this case validated our department's integrated emergency medicine model, the first in the State of Israel.
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Paradise C, Carlan SJ, Holloman C. Spontaneous uterine cornual rupture at 26 weeks' gestation in an interstitial heterotopic pregnancy following in vitro fertilization. JOURNAL OF CLINICAL ULTRASOUND : JCU 2016; 44:322-325. [PMID: 26677169 DOI: 10.1002/jcu.22322] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 11/06/2015] [Indexed: 06/05/2023]
Abstract
Interstitial implantation in a heterotopic pregnancy is extremely rare, and despite currently available diagnostic modalities, early identification of an interstitial ectopic pregnancy remains difficult. This report describes a case of spontaneous cornual rupture at 26 weeks' gestation in a woman with diamniotic dichorionic twins that resulted in live births. The patient had previously undergone laparoscopic bilateral salpingectomy, and the pregnancy was conceived with in vitro fertilization. Interstitial implantation in a heterotopic pregnancy can go unrecognized, resulting in increased maternal and infant morbidity and mortality. © 2015 Wiley Periodicals, Inc. J Clin Ultrasound 44:322-325, 2016.
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Affiliation(s)
- Courtney Paradise
- Department of Obstetrics and Gynecology, Orlando Health, Orlando, FL
| | - S J Carlan
- Department of Obstetrics and Gynecology, Orlando Health, Orlando, FL
| | - Conisha Holloman
- Department of Obstetrics and Gynecology, Orlando Health, Orlando, FL
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7
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Abstract
Congenital uterine anomalies are more common than previously recognized. While many women will have no symptoms or problems, some women with congenital uterine anomalies have increased risks of adverse outcomes during pregnancy. This article presents a case study of a woman with a congenital uterine anomaly leading to spontaneous rupture of her unscarred uterus remote from term. The most common types of congenital uterine anomalies and their associated reproductive risks are reviewed. Evaluation of congenital uterine anomalies and management alternatives are discussed.
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Tuştaş Haberal E, Çekmez Y, Ulu İ, Divlek R, Göçmen A. Placenta percreta with concomitant uterine didelphys at 18 weeks of pregnancy: a case report and review of the literature. J Matern Fetal Neonatal Med 2015; 29:3445-8. [PMID: 26653847 DOI: 10.3109/14767058.2015.1130819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIM The aim of this paper is to draw the attention of the clinicians on placenta percreta detected along with uterine anomalies in early second trimester. CASE PRESENTATION A 35-year-old, gravida 2 parity 1 woman at 18 weeks of pregnancy was admitted to our emergency unit with abdominal pain. In ultrasound exam, a live fetus compatible with 18 weeks of gestation, hemoperitoneum and a solid mass adjacent to the uterus were detected. An emergent laparotomy was decided because of hemorrhagic shock findings. In the operation, uterine didelphys and an active bleeding area from placenta percreta on the anterior wall of the uterus where pregnancy was settled were detected. In the simultaneous vaginal examination two cervixes and a longitudinal vaginal septum were seen. Supracervical hemihysterectomy was performed. CONCLUSION Placenta percreta is a rare clinical entity with an elevated perinatal mortality. Uterine anomalies are risk factors for placental adhesion anomalies. Clinical suspicion is vital for early diagnosis and timely management.
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Affiliation(s)
- Esra Tuştaş Haberal
- a Department of Obstetrics and Gyneacology , Ümraniye Medical and Research Hospital , İstanbul , Turkey
| | - Yasemin Çekmez
- a Department of Obstetrics and Gyneacology , Ümraniye Medical and Research Hospital , İstanbul , Turkey
| | - İpek Ulu
- a Department of Obstetrics and Gyneacology , Ümraniye Medical and Research Hospital , İstanbul , Turkey
| | - Radia Divlek
- a Department of Obstetrics and Gyneacology , Ümraniye Medical and Research Hospital , İstanbul , Turkey
| | - Ahmet Göçmen
- a Department of Obstetrics and Gyneacology , Ümraniye Medical and Research Hospital , İstanbul , Turkey
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9
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Bharatnur S, Hebbar S, Shyamala G. Early second trimester uterine scar rupture. BMJ Case Rep 2013; 2013:bcr-2013-200960. [PMID: 24326433 DOI: 10.1136/bcr-2013-200960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Spontaneous uterine scar rupture can be lethal in pregnant women. A spontaneous uterine scar rupture in the early mid-trimester is rare and difficult to diagnose. This is a case of a 30-year-old woman (G2P1L1) at 19 weeks of gestation and having undergone a previous caesarean section presented with acute abdomen in shock. Laparotomy revealed a uterine scar rupture, which was resutured after evacuation of products of conception. This case merits that the uterine rupture should be considered as a differential diagnosis in pregnant women presenting with acute abdomen. In this case, although there was uterine rupture in the second trimester and a complete placental separation, fetus was alive which is quite unusual in patients presenting with rupture uterus.
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10
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Timor-Tritsch IE, Monteagudo A. Unforeseen consequences of the increasing rate of cesarean deliveries: early placenta accreta and cesarean scar pregnancy. A review. Am J Obstet Gynecol 2012; 207:14-29. [PMID: 22516620 DOI: 10.1016/j.ajog.2012.03.007] [Citation(s) in RCA: 366] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Revised: 01/28/2012] [Accepted: 03/09/2012] [Indexed: 11/29/2022]
Abstract
This review concentrates on 2 consequences of cesarean deliveries that may occur in a subsequent pregnancy. They are the pathologically adherent placenta and the cesarean scar pregnancy. We explored their clinical and diagnostic as well as therapeutic similarities. We reviewed the literature concerning the occurrence of early placenta accreta and cesarean section scar pregnancy. The review resulted in several conclusions: (1) the diagnosis of placenta accreta and cesarean scar pregnancy is difficult; (2) transvaginal ultrasound seems to be the best diagnostic tool to establish the diagnosis; (3) an early and correct diagnosis may prevent some of their complications; (4) curettage and systemic methotrexate therapy and embolization as single treatments should be avoided if possible; and (5) in the case of cesarean scar pregnancy, local methotrexate- and hysteroscopic-directed procedures had the lowest complication rates.
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Affiliation(s)
- Ilan E Timor-Tritsch
- Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY 10016, USA.
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11
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Anand AK, Gupta S, Gupta A. Placenta percreta causing spontaneous rupture of the uterus. J Obstet Gynaecol India 2012; 63:64-5. [PMID: 24431603 DOI: 10.1007/s13224-012-0132-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2009] [Accepted: 11/17/2010] [Indexed: 12/01/2022] Open
Affiliation(s)
- Amandeep K Anand
- Department of Obstetrics and Gynecology, Government Medical College and Associated Hospitals (SMGS), Jammu, J&K India
| | - Shashi Gupta
- Department of Obstetrics and Gynecology, Government Medical College and Associated Hospitals (SMGS), Jammu, J&K India
| | - Amita Gupta
- Department of Obstetrics and Gynecology, Government Medical College and Associated Hospitals (SMGS), Jammu, J&K India
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12
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Jang DG, Lee GSR, Yoon JH, Lee SJ. Placenta percreta-induced uterine rupture diagnosed by laparoscopy in the first trimester. Int J Med Sci 2011; 8:424-7. [PMID: 21814475 PMCID: PMC3149421 DOI: 10.7150/ijms.8.424] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2011] [Accepted: 07/06/2011] [Indexed: 11/05/2022] Open
Abstract
Spontaneous uterine rupture is lethal in pregnant women. Placenta percreta-induced spontaneous uterine rupture in the first trimester is extremely rare and difficult to diagnose. A 35-year-old pregnant woman, with a history of 2 vaginal deliveries and 2 spontaneous abortions treated by dilatation and curettage, was admitted to the emergency department because of sudden severe abdominal pain; the gestational age as calculated by sonography was 14 weeks. Diagnostic laparoscopy was considered for surgical abdomen and fluid collection that was noted in sonography. During laparoscopy, uterine rupture with massive bleeding was detected; therefore, total abdominal hysterectomy was performed. The patient was discharged without any complications. Pathological analysis of the uterine specimen revealed placenta percreta to be the cause of the rupture. Uterine rupture should be considered in the differential diagnosis in all pregnant women who present with acute abdomen, show fluid collection in the peritoneal cavity. In addition, we recommend laparoscopy for the investigation of acute abdomen with unclear diagnosis in the first trimester of pregnancy.
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Affiliation(s)
- Dong Gyu Jang
- Department of Obstetrics and Gynecology, College of Medicine, St. Vincent's Hospital, The Catholic University of Korea, Seoul, Korea
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13
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Rosen T. Placenta accreta and cesarean scar pregnancy: overlooked costs of the rising cesarean section rate. Clin Perinatol 2008; 35:519-29, x. [PMID: 18952019 DOI: 10.1016/j.clp.2008.07.003] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
An unintended consequence of the rising cesarean section rate is abnormal placentation in subsequent pregnancies, leading to the clinical complications of placenta accreta and cesarean scar pregnancies. Both of these clinical entities are associated with high rates of maternal morbidity and mortality. This article reviews the potential mechanisms by which uterine scarring may lead to abnormal trophoblast invasion, the association of cesarean section with placenta accreta and scar pregnancies, current management, and suggestions for future research to reduce the incidence of these potentially devastating complications of pregnancy.
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Affiliation(s)
- Todd Rosen
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, 622 West 168th Street, PH 16-66, Columbia University, New York, NY 10032, USA.
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14
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Affiliation(s)
| | - Kim Michael
- University of Nebraska Medical Center, Omaha, Nebraska
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15
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An unusual case of hemoperitoneum: uterine rupture at 9 weeks gestational age. J Emerg Med 2007; 33:285-7. [PMID: 17976559 DOI: 10.1016/j.jemermed.2007.01.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2006] [Revised: 01/22/2007] [Accepted: 01/24/2007] [Indexed: 11/20/2022]
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16
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Esmans A, Gerris J, Corthout E, Verdonk P, Declercq S. Placenta percreta causing rupture of an unscarred uterus at the end of the first trimester of pregnancy: Case report. Hum Reprod 2004; 19:2401-3. [PMID: 15298972 DOI: 10.1093/humrep/deh421] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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.
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Affiliation(s)
- A Esmans
- Department of Obstetrics and Gynecology, Lindendreef 1, 2020 Antwerp, Belgium
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17
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Hlibczuk V. Spontaneous uterine rupture as an unusual cause of abdominal pain in the early second trimester of pregnancy. J Emerg Med 2004; 27:143-5. [PMID: 15261356 DOI: 10.1016/j.jemermed.2004.03.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2003] [Revised: 01/12/2004] [Accepted: 03/02/2004] [Indexed: 11/22/2022]
Abstract
A case of placenta percreta causing spontaneous uterine rupture is presented. This is a rare condition, which may present in the antepartum period as abdominal pain, with or without signs of hemorrhagic shock. This entity can lead to significant morbidity and mortality if not aggressively managed. A discussion follows on the pathophysiology, incidence, risk factors, presentation and management of this condition.
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Affiliation(s)
- Veronica Hlibczuk
- Department of Emergency Medicine, Lincoln Medical & Mental Health Center, Bronx, New York, USA
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18
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Vyjayanthi S, Rajesh U, Bloomfield TH. Haemoperitoneum due to placenta percreta in the third trimester mimicking placental abruption. J OBSTET GYNAECOL 2002; 22:690-1. [PMID: 12554272 DOI: 10.1080/014436102762062394] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- S Vyjayanthi
- Department of Obstetrics and Gynaecology,West Wales General Hospital, Carmarthen, UK
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19
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Höpker M, Fleckenstein G, Heyl W, Sattler B, Emons G. Placenta percreta in week 10 of pregnancy with consecutive hysterectomy: case report. Hum Reprod 2002; 17:817-20. [PMID: 11870142 DOI: 10.1093/humrep/17.3.817] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Placenta percreta in early pregnancy is rare and has been documented in only a few cases. We report on a patient with abdominal pain in week 10 of pregnancy. Sonography revealed a defective embryonic development and the absence of a border line between trophoblast and myometrium, as well as invasive growth in the region of isthmocervical transition, so curettage was performed. Heavy bleeding at this stage made a hysterectomy necessary. Histological examination revealed a placenta percreta. Because of possible complications, the therapy of choice for a placenta percreta is a hysterectomy, as was performed in this case.
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Affiliation(s)
- Martin Höpker
- Department of Obstetrics and Gynecology, Georg August University, Robert-Koch-Strasse 40, D-37075 Göttingen, Germany
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20
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Morken NH, Henriksen H. Placenta percreta--two cases and review of the literature. Eur J Obstet Gynecol Reprod Biol 2001; 100:112-5. [PMID: 11728672 DOI: 10.1016/s0301-2115(01)00422-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Two cases of placenta pecreta confirmed histologically were treated conservatively with retention of the uterus. Both later went on to have successful pregnancies.
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Affiliation(s)
- N H Morken
- Department of Obstetrics and Gynaecology, Telemark Central Hospital, Ulefossveien 52-56, 3710 Skien, Norway.
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21
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Tews G, Ebner T, Yaman C, Hartl J. Maternal ascites into the abdomen in a patient with status post adnexectomy and uterine rupture. Acta Obstet Gynecol Scand 2001. [DOI: 10.1034/j.1600-0412.2001.080005474.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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22
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Inovay J, Marton T, Urbancsek J, Kádár Z, Altdorfer K, Papp Z. Spontaneous bilateral cornual uterine dehiscence early in the second trimester after bilateral laparoscopic salpingectomy and in-vitro fertilization: case report. Hum Reprod 1999; 14:2471-3. [PMID: 10527971 DOI: 10.1093/humrep/14.10.2471] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
A bilateral cornual uterine dehiscence is reported, which occurred 14 weeks after in-vitro fertilization (IVF) in a patient having a medical history of previous bilateral salpingectomy via laparoscopy. Uterine rupture is a rare obstetric complication usually occurring during the third trimester of pregnancy within a uterus which has previously undergone an operation. Ectopic pregnancy is a well known complication of IVF. Post-salpingectomy cornual localization with rupture has also been published. Possible causes are discussed and the attention of the counselling physician is directed to the necessary awareness of such a complication in this high risk population. The reported case is an extreme rarity: a similar case has not been previously published in the literature.
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Affiliation(s)
- J Inovay
- 1st Department of Obstetrics and Gynecology, Semmelweis University Medical School, Baross utca 27, H-1088 Budapest, Hungary
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23
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Kashyap R, Fliegner JR. Spontaneous mid-trimester uterine rupture. THE AUSTRALIAN AND NEW ZEALAND JOURNAL OF SURGERY 1999; 69:685-6. [PMID: 10515351 DOI: 10.1046/j.1440-1622.1999.01668.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- R Kashyap
- Royal Women's Hospital and Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia
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