Placenta percreta complicated with uterine rupture in the third trimester: A case report

Abstract

Placenta accreta is characterized by the abnormal attachment of the placenta to the myometrium without the usual presence of decidua in between. In its percreta form, this attachment extends deeply into the myometrial wall, reaching the serosa and occasionally affecting nearby organs like the bladder and rectum. The advancement of these conditions often leads to hemorrhagic complications, significantly jeopardizing maternal well-being. We present a case of placenta percreta presenting with hemorrhage and hemoperitoneum at 31 weeks' gestation due to a spontaneous uterine rupture. Swift action with a total hysterectomy for maternal rescues was performed, unfortunately the fetus was already dead on arrival. Placenta accreta spectrum occurs when the placenta adheres abnormally to the myometrium and serosa rather than to the decidua. Spontaneous uterine rupture caused by placenta accreta is a rare and serious complication leading to hemorrhage and in sometimes unfortunately to mortality, as was the case in our patient. Antenatal diagnosis by ultrasound is recommended to avoid complications and improve management. Definitive diagnosis is made after pathological examination. The incidence of placenta percreta has surged alongside the notable increase in cesarean section rates. While it remains rare, this condition presents a potentially fatal complication. Early antenatal diagnosis plays a crucial role in mitigating the risk of complications and maternal mortality. • Placenta accreta spectrum PAS is characterizing multiple variants of abnormal placental insertion. • The incidence of placenta accreta has been steadily and dramatically increasing in recent years due to the increasing rate of cesarean sections. • The most severe complication is hemorrhage and uterine rupture. • Surgical treatment is most often recommended.