Placenta percreta induced uterine rupture at 15 weeks of gestation: an unusual case

Spontaneous rupture of uterus during early pregnancy due to placenta percreta is a rare complication, which is potentially life-threatening to both mother & fetus and also difficult to diagnose. A 27 years old pregnant woman with history of previous one caesarean section 2 years back was referred to our emergency department with severe anaemia and breathlessness. On examination patient was in hypovolemic shock. Ultrasonography revealed massive fluid collection in peritoneal cavity, an intrauterine anomalous foetus of 15 weeks and low-lying placenta. Paracentesis was positive for blood. On laparotomy there was haemoperitoneum of about 3 litres with placenta perforating through the lower segment of uterus. Even after all measures to conserve uterus, due to uncontrolled bleeding hysterectomy was performed. Postoperative period was uneventful. Pathological analysis of the specimen confirmed our diagnosis of placenta percreta. Though uterine rupture is rare in early trimester, it may be considered in a patient with haemoperitoneum with a scarred uterus, which can be due to placenta percreta also