چكيده لاتين :
The placental adhesive disorders such as placenta accreta and
placenta percreta are the rare causes of serious obstetric hemorrhages.
They are associated with high maternal morbidity and
mortality. Placenta percreta is usually diagnosed in the third
trimester of pregnancy as a massive postpartum hemorrhage
when an attempt to remove the placenta reveals lack of a
cleavage plane. Here we report an unusual presentation of placenta
percreta as hemoperitoneum and hemorrhagic shock in
the third trimester of pregnancy. A 33-year-old woman was
admitted to hospital at the 35th weeks of gestation with abdominal
pain and hemorrhagic shock. Laparotomy was immediately
performed because of intra-abdominal bleeding. Upon
inspection, a posterior laceration of the uterus was noted.
Pathologic investigation of the uterus showed placenta percreta.
The patient recovered uneventfully. Spontaneous rupture
of the uterus can be occured in the absence of uterine
trauma. In the differential diagnosis of a pregnant woman presenting
with hypotension, abdominal pain, and fetal death, rupture
of the uterus caused by placenta percreta should be considered.
Rapid diagnosis, blood transfusion, and emergency laparotomy
are the key steps in successful management.
Iran J Med Sci 2009; 34(2): 145-148.
