Uterine rupture secondary to placenta percreta in a near-term pregnant woman with a history of hysterotomy

2010 ◽  
Vol 37 (1) ◽  
pp. 71-74 ◽  
Author(s):  
Ching-Hui Chen ◽  
Peng-Hui Wang ◽  
Jui-Yu Lin ◽  
Yen-Hsieh Chiu ◽  
Hong-Ming Wu ◽  
...  
Keyword(s):  
Pregnant Woman ◽  
Uterine Rupture ◽  
Placenta Percreta ◽  
History Of ◽  
Near Term

scholarly journals Placenta Percreta: An Unusual Etiology for Spontaneous Rupture of Uterus Near Term

2014 ◽  
Vol 6 (3) ◽  
pp. 180-182
Author(s):  
Anupam Varshney ◽  
Neerja LNU ◽  
Manju Varma ◽  
RK Thakral
Keyword(s):  
Pregnant Women ◽  
Uterine Rupture ◽  
Spontaneous Rupture ◽  
Placenta Percreta ◽  
Emergency Laparotomy ◽  
Lower Segment Cesarean Section ◽  
Spontaneous Uterine Rupture ◽  
History Of ◽  
Rupture Of Uterus ◽  
Near Term

ABSTRACT Uterine rupture is a life-threatening complication in pregnancy with an incidence of 0.07%, out of which 80% are spontaneous rupture. Placenta percreta is the rarest form of placental implantation abnormalities, with an incidence 1 in 2500 pregnant women.1,2 Spontaneous uterine rupture due to placenta percreta is very rare, with an incidence of 1 in 4,366 pregnant women.3 It often occurs in patients with a history of scar in the uterus.4 Placenta percreta-induced spontaneous uterine rupture at term with previous lower segment cesarean section (LSCS) is difficult to diagnose. A 25-year-old pregnant woman, with history of one incomplete abortion treated by dilatation and curettage followed by a vaginal delivery with stillbirth and one LSCS again with stillbirth at term, was admitted in the emergency ward with history of approx 9 months amenorrhea, breathlessness, pain in abdomen (unable to lie down or even sit), vomiting and loss of fetal movements for last 24 hours. O/E: GC fair, afebrile, Pallor +++, pedal edema +, pulse 100/minutes regular, resp. rate; 40/minutes, thoracic, BP 110/70 mm Hg, lung fields clear with no abnormality detected in heart. On P/A: skin was stretched and a Pfannensteil scar healed by primary intention was present Abdomen tense, tender therefore fundal height could not be assessed. Fetal parts were not palpable and lie/presentation could not be made out. FHS were absent. On P/V; os closed with uneffaced cervix, presenting part could not be made out and was high. No bleeding or leaking per-vaginum was present. Hb 6.7 gm%, TLC 15600, DLC P90, L8, E2, M0. Ultrasound done on 27.5.12 (one month back) outside revealed 32.3 weeks gestation with normal scar thickness, placenta located in upper segment, grade I. No comment was made on the interface between placenta and myometrium in ultrasound report. Patient was subjected to emergency laparotomy, massive hemoperitoneum was found. Examination of uterus revealed an intact previous scar. A full term male stillborn baby was delivered by uterine scar (LSCS) on 21.6.2012, at 10.30 pm The placenta could not be delivered as there was no plain of cleavage between placenta and myometrium. Uterus was exteriorized and to surprise there was a rent of about 3 × 2 cm at left cornua, placental tissue peeping out on removing the clots. Subtotal hysterectomy was performed. Three units blood were transfused. Postoperative period was uneventful and the patient was discharged in satisfactory condition on 9th day. Histopathological examination of the uterine specimen revealed placenta percreta. To conclude uterine rupture should be considered in the differential diagnosis in pregnant women who present with acute abdomen with or without shock. How to cite this article Neerja, Varma M, Thakral RK, Varshney A. Placenta Percreta: An Unusual Etiology for Spontaneous Rupture of Uterus Near Term. J South Asian Feder Obst Gynae 2014;6(3):180-182.

scholarly journals Massive Adherent Placenta, Placenta Percreta

2021 ◽  
Vol 6 (1) ◽  
pp. 108-121
Author(s):  
Eric Edwin Yuliantara ◽  
◽  
Nutria Widya Purna Anggraini ◽  
Dympna Prameilita Prisasanti ◽  
◽  
...  
Keyword(s):  
Risk Factors ◽  
Uterine Rupture ◽  
Placenta Previa ◽  
Vital Signs ◽  
Placenta Percreta ◽  
High Morbidity ◽  
Sonographic Examination ◽  
Adherent Placenta ◽  
Operative Care ◽  
History Of

Background: Adherent placentas including placenta accreta, increta and percreta are conditions where there is abnormal implantation of all or part of the placenta on the myometrial wall. Massive adherent placenta has high morbidity and mortality rates in both mother and fetus. There is a positive correlation between the incidence of adherent placenta and the increase in cesarean section rates worldwide. Identification of risk factors, antenatal diagnosis, accurate preoperative preparation, multidisciplinary management, and appropriate counseling are the main management of adherent placenta to reduce maternal morbidity. Case Presentation: A woman, G5P3A1, age 36 years pregnant 37 weeks, complained loudly regularly since 6 hours before admission to hospital. There is a history of CS as much as 3x with indications of 2x Premature rupture of the membranes and uterine rupture, as well as a history of curettage (1x). Physical examination showed that the general condition was good, and composting, vital signs were within normal limits. Abdomen palpable single fetus, intrauterine, elongated, head presentation, left back, moderate his (+), FHR 150 x/minute. The results of prenatal sonography examination showed that neither placenta previa nor massive adherent placenta was found. The preoperative diagnosis was inparticular stage I latent phase with a history of SC 3 times. Results: An emergency Caesarean section was performed. Durante surgery showed severe adhesions of the placenta, uterine wall and bladder. The diagnosis of placenta percreta was confirmed, uterine resection was performed on the perreta section, hysterography as well as adhesiolysis and MOW sterilization. The results of the PA examination support the diagnosis of placenta percreta. Conclusion: Massive adherent placenta, placenta percreta was not diagnosed in this case because there were no clinical features or prenatal sonography that supported the diagnosis of placenta percreta. A history of trauma to the uterus due to uterine rupture, history of CS and curettage were risk factors for placenta percreta in this case. The incidence rate of placenta percreta with a history of SC 3 times without placenta previa on the previous sonographic examination was 0.1%. Operative management to manage bleeding and post operative care have been carried out according to the procedure so as to avoid mortality. Keywords: massive adherent placenta, placenta percreta, case report Correspondence: Eric Edwin Yuliantara. Department Obstetrics and Gynecology, Faculty of Medicine Universitas Sebelas Maret/ dr. Moewardi General Hospital Surakarta. Jl Kolonel Sutarto 132, Surakarta, Central Java. Email: edwinericog- @staff.uns.ac.id. Mobile: 08122618769.

scholarly journals To Give or Not to Give: RhD Immunoglobulin for an RHD*39 Pregnant Woman with Sickle Cell Disease

2021 ◽  
pp. 1-5
Author(s):  
Justin E. Juskewitch ◽  
Craig D. Tauscher ◽  
Sheila K. Moldenhauer ◽  
Jennifer E. Schieber ◽  
Eapen K. Jacob ◽  
...  
Keyword(s):  
Pregnant Woman ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Pregnancy Termination ◽  
Acute Chest Syndrome ◽  
Cell Disease ◽  
Childbearing Age ◽  
Procedural Complications ◽  
History Of ◽  
Chronic Hemolysis

Introduction: Patients with sickle cell disease (SCD) have repeated episodes of red blood cell (RBC) sickling and microvascular occlusion that manifest as pain crises, acute chest syndrome, and chronic hemolysis. These clinical sequelae usually increase during pregnancy. Given the racial distribution of SCD, patients with SCD are also more likely to have rarer RBC antigen genotypes than RBC donor populations. We present the management and clinical outcome of a 21-year-old pregnant woman with SCD and an RHD*39 (RhD[S103P], G-negative) variant. Case Presentation: Ms. S is B positive with a reported history of anti-D, anti-C, and anti-E alloantibodies (anti-G testing unknown). Genetic testing revealed both an RHD*39 and homozygous partial RHCE*ceVS.02 genotype. Absorption/elution testing confirmed the presence of anti-G, anti-C, and anti-E alloantibodies but could not definitively determine the presence/absence of an anti-D alloantibody. Ms. S desired to undergo elective pregnancy termination and the need for postprocedural RhD immunoglobulin (RhIG) was posed. Given that only the G antigen site is changed in an RHD*39 genotype and the potential risk of RhIG triggering a hyperhemolytic episode in an SCD patient, RhIG was not administered. There were no procedural complications. Follow-up testing at 10 weeks showed no increase in RBC alloantibody strength. Discussion/Conclusion: Ms. S represents a rare RHD*39 and partial RHCE*ceVS.02 genotype which did not further alloimmunize in the absence of RhIG administration. Her case also highlights the importance of routine anti-G alloantibody testing in women of childbearing age with apparent anti-D and anti-C alloantibodies.

scholarly journals Spontaneous Uterine Rupture in a Preterm Pregnancy following Myomectomy

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Claire Sutton ◽  
Prue Standen ◽  
Jade Acton ◽  
Christopher Griffin
Keyword(s):  
Abdominal Pain ◽  
Caesarean Section ◽  
Uterine Rupture ◽  
Good Condition ◽  
Acute Onset ◽  
Uterine Wall ◽  
Unusual Presentation ◽  
Postoperative Course ◽  
Spontaneous Uterine Rupture ◽  
History Of

A 44-year-old nulliparous woman was transferred to a tertiary obstetric hospital for investigation of acute onset abdominal pain. She was at gestation of 32 weeks and 2 days with a history of previous laparoscopic fundal myomectomy. An initial bedside ultrasound demonstrated oligohydramnios. Following an episode of increased pain early the following morning, a formal ultrasound diagnosed a uterine rupture with the fetal arm extending through a uterine rent. An uncomplicated classical caesarean section was performed and the neonate was delivered in good condition but with a bruised and oedematous right arm. The neonate was transferred to the Special Care Nursery for neonatal care. The patient had an uncomplicated postoperative course and was discharged home three days following delivery. This is an unusual presentation of uterine rupture following myomectomy where the fetal arm had protruded through the uterine wall.

scholarly journals Nationwide population-based cohort study of adverse obstetric outcomes in pregnancies with myoma or following myomectomy: Retrospective cohort study

2020 ◽  
Author(s):  
Se Jin Lee ◽  
Hyun Sun Ko ◽  
Sunghun Na ◽  
Jin Young Bae ◽  
Won Joon Seong ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cesarean Section ◽  
Uterine Rupture ◽  
Placenta Previa ◽  
Multivariate Logistic Regression Analysis ◽  
Population Based ◽  
Obstetric Outcomes ◽  
Nulliparous Women ◽  
History Of ◽  
Adverse Pregnancy

Abstract Background: Our objective was to evaluate risks of adverse obstetric outcomes in pregnancies with myoma(s) or in pregnancies following myomectomy. Methods: We analyzed the national health insurance database, which covers almost the entire Korean population, between 2004 and 2015. The risks of adverse pregnancy outcomes in pregnancies with myoma(s) or in pregnancies following myomectomy, compared to those in women without a diagnosed myoma, were analyzed in multivariate logistic regression analysis. Results: During the study period, 38,402 women with diagnosed myoma(s), 9,890 women with a history of myomectomy, and 740,675 women without a diagnosed myoma gave birth. Women with a history of diagnosed myoma(s) and women with a history of myomectomy had significantly higher risks of cesarean section (aOR 1.13, 95% CI 1.1-1.16 and aOR 7.46, 95% CI 6.97-7.98, respectively) and placenta previa (aOR 1.41, 95% CI 1.29-1.54 and aOR 1.58, 95% CI 1.35-1.83, respectively), compared to women without a diagnosed myoma. And the risk of uterine rupture was significantly higher in women with previous myomectomy (aOR 12.78, 95% CI 6.5-25.13), compared to women without a diagnosed myoma, which was much increased (aOR 41.35, 95% CI 16.18-105.69) in nulliparous women. The incidence of uterine rupture was the highest at delivery within one year after myomectomy and decreased over time after myomectomy. Conclusions: Women with a history of myomectomy had significantly higher risks of cesarean section and placenta previa compared to women without a diagnosed myoma.

scholarly journals Rotura Uterina às 18 Semanas de Gravidez no Contexto de Útero Malformado

2016 ◽  
Vol 29 (10) ◽  
pp. 667
Author(s):  
Emídio Vale-Fernandes ◽  
Neusa Teixeira ◽  
Alexandra Cadilhe ◽  
Maria José Rocha
Keyword(s):  
Uterine Rupture ◽  
Female Genital Tract ◽  
Obstetric Outcomes ◽  
Placenta Increta ◽  
Abnormal Placentation ◽  
History Of ◽  
Uterine Malformations ◽  
The Right ◽  
Congenital Uterine Anomaly ◽  
Female Genital

Birth defects of the female genital tract are relatively common and often asymptomatic. Despite the pregnancy outcome can be favorable, adverse obstetric outcomes are described in women with uterine malformations. The authors report the case of an obstetric emergency which enhances the possibility of a very adverse and rare outcome of uterine rupture in a left hemi-cavity of a bicornuate uterus away from the term, at 18 weeks of pregnancy, in a pregnant woman with history of caesarean in the right hemi-cavity and with placenta increta. A malformed uterus with a primitive type cavity has lower distensibility of the wall with the progression of the pregnancy and facilitates the development of abnormal placentation forms, increasing the risk of uterine rupture in the first and second trimesters. The knowledge of the existence of a congenital uterine anomaly in the preconceptional period is of primary importance.

scholarly journals Acute Hemoperitoneum after Administration of Prostaglandin E2for Induction of Labour

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Zhenyu Zhang ◽  
Jiangyan Lou
Keyword(s):  
Laparoscopic Surgery ◽  
Pregnant Woman ◽  
Pregnant Women ◽  
Stage Iv ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Prostaglandin E ◽  
History Of

Prostaglandin E2is widely used in obstetrics and is thought to be relatively safe for cervical ripening and induction of labour. Here we present a case in which acute hemoperitoneum was observed after administration of prostaglandin E2in a pregnant woman. The patient had a history of endometriosis, and a severe pelvic adhesion (ASRM stage IV) was found during her last laparoscopic surgery 3 years previously. In cases with endometriosis, use of prostaglandin E2for induction of labour in pregnant women must be done cautiously.

scholarly journals Management of Locally Advanced Esthesioneuroblastoma in a Pregnant Woman

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Inês Maria Guerreiro ◽  
Cláudia Vieira ◽  
André Soares ◽  
António Braga ◽  
Manuel Jácome ◽  
...  
Keyword(s):  
Pregnant Woman ◽  
Nasal Obstruction ◽  
Standard Treatment ◽  
Combined Treatment ◽  
Locally Advanced ◽  
Cervical Lymphadenopathy ◽  
Complete Response ◽  
High Grade ◽  
History Of ◽  
Worse Prognosis

Esthesioneuroblastoma (ENB) is a rare malignant tumor that commonly develops in the upper nasal cavity. Standard treatment is not established, especially in locally advanced disease which portends the worse prognosis. Hereby, we report a case of a 27-year-old, 23-week pregnant woman, with a 2-month history of progressively growing right cervical lymphadenopathy, nasal obstruction, anosmia, frequent episodes of epistaxis, and right frontal headache. Imagiological evaluation revealed a lesion with 7×5,2×3,2 cm in the nasal fossae with extension to the ethmoidal complex and right olfactive fend and invasion of the endocranial compartment associated with lymphadenopathy. The biopsy revealed a high-grade EBN. Neoadjuvant chemotherapy with cisplatin and etoposide was administrated during pregnancy and continued after delivery up to 6 cycles of treatment with partial response. Radiotherapy followed, with complete response. This case report is intended to highlight that a high grade of suspicion should be kept in the presence of nonspecific symptoms of nasal obstruction, anosmia, facial pain, and/or headache and focus that chemotherapy is an important component of a combined-treatment modality for locally advanced ENB that can be used during pregnancy in a lifesaving situation.

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