Spontaneous Uterine Rupture Due to Placenta Percreta in a 17-Week Twin Pregnancy.

Abstract

Spontaneous rupture of previous uterine scar due to placenta percreta in early second trimester is a very rare and serious complication. A27-year fourth gravida, second para with previous two lower segment caesarean sections, presented at 17-week of twin pregnancy with acute abdominal pain. Ultrasonograghy revealed 17-week diamniotic-dichorionic twin pregnancy with alive fetuses. The placenta of the first twin was anterior, low lying covering the internal os and penetrating through the entire thickness of the lower uterine wall laterally. Significant hemoperitoneum was seen. Emergency laparotomy showed rupture of previous uterine scar with placenta percreta bleeding actively. Atransverse fundal incision was given to deliver the twins and total abdominal hysterectomy with preservation of both ovaries was performed. The patient was discharged on fourth postoperative day without any complication. Histopathology of specimen of the uterus confirmed placenta percreta to be the cause of uterine rupture.