Focal Placenta Accreta and Spontaneous Uterus Rupture in the Post-Partum

Abstract

Introduction: Uterine rupture occurs when the integrity of the myometrial wall is compromised. It could interest the uterine body (prior to labour) or the lower segment (during labour). The main causes of uterine rupture are obstetric anamnestic factors and/or the administration of oxytocin. Case presentation:The authors report the case of a 42 years old patient without risk factors for uterine rupture. After the expulsion of the placenta the mother had continuous blood loss, for this reason she was subjected to subtotal hysterectomy. Histological examination revealed the absence of decidua in the uterine fundus and thinning of the myometrium. Histological examination of the lesion at the site commented that there was infiltration of the chorionic villi into the endometrium and this is undoubtedly the features of placenta accreta. Conclusion: The authors emphasize the importance of careful observation of the placenta after delivery for the absence of even small placental cotyledons in order to eliminate a rare risk factor for silent uterine rupture.