Placenta percreta as a cause of massive intraabdominal bleeding

Czech version

Authors: M. Rolná ¹; P. Matlák ^1,2; J. Dvořáčková ³
Authors‘ workplace: Gynekologicko-porodnická klinika FN, Ostrava, přednosta doc. MUDr. O. Šimetka, Ph. D., MBA ¹; Gynekologicko-porodnická klinika LF OU, přednosta doc. MUDr. O. Šimetka, Ph. D., MBA ²; Ústav patologie FN, Ostrava, přednostka doc. MUDr. J. Dvořáčková, Ph. D. ³
Published in: Ceska Gynekol 2017; 82(6): 478-481

Overview

Objective:
To inform about a rare cause of massive intraabdominal bleeding due to perforation of uterine corner by unrecognized placenta percreta.

Design:
Case report.

Setting:
Department of Gynecology and Obstetrics, University Hospital Ostrava.

Case report:
We report a case of acute haemoperitoneum in pregnant woman at 34th week of gestation. We have detected the cause of the bleeding during emergency caesarean section –⁠ perforation of left uterine corner by placenta percreta.

Conclusion:
Placenta percreta is the most severe form of abnormal placental villous adherence. In rare cases, chorionic villi may penetrate surrounding organs and cause acute intraabdominal bleeding. Due to increasing number of surgical interventions on uterus, these disorders are on the rise. It is crucial to anticipate an abnormal placental villous adherence in women with atypical placenta localization. These women should be thoroughly observed and referred to perinatal center with intermediary or intensive care for further management before delivery.

Keywords:
placenta percreta, hemoperitoneum, caesarean section, postpartum hysterectomy

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