FUNDAL PLACENTA PERCRETA WITH UTERINE RUPTURE– A CASE STUDY

Samina Ashraf; Shagufta Yasmeen Rather; Asima Afzal; Waseeqa Nigeen

Volume : VI, Issue : XII, December - 2017

FUNDAL PLACENTA PERCRETA WITH UTERINE RUPTURE– A CASE STUDY

Samina Ashraf, Shagufta Yasmeen Rather, Asima Afzal, Waseeqa Nigeen

Abstract :

Placenta percreta is a type of an abnormal placentation wherein the placental villi penetrate the myometrium and reach up to serosa. High risk factors include placenta previa, previous caesarean section, previous D&C, increased maternal age, high parity, previous myomectomy, previous Asherman�s syndrome and unusual high levels of alpha fetoproteins. Usually the placenta percreta is found in lower uterine segment especially in the patients with placenta previa and previous caesarean deliveries. We report a case of third trimester uterine rupture in a patient with fundal placenta. A 29 year old young patient with previous caesarean delivery presented to us with preterm rupture of memanes and leaking since 8 hours. Ultrasonography shows single live fetus 32 weeks with fundal placenta with decreased liquor. She was managed with intravenous antibiotics and intravenous betamethasone for lung maturity. After 7 hours of hospital admission, suddenly patient�s condition detoriated with abdominal pain ,tenderness, excessive perspiration and unexplained shock. Emergency laparotomy was done. There was uterine rupture at fundal area with placenta percreta. Baby was delivered with low Apgar score but was resuscitated. Subtotal hysterectomy was done. This case highlights that plecenta percreta can be encountered in normal located placenta (upper segment placenta). It is crucial to maintain high index of suspicion for placenta percreta particularly in patients with previous caesarean deliveries.