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Second trimester placenta percreta presenting as acute abdomen
Lauren Dew1, Steven Harris1, Nicole Yost1
1Department of Obstetrics and Gynecology (Dew, Harris), Division of Maternal and Fetal Medicine (Yost, Magee), and Department of Radiology (dePrisco), Baylor University Medical Center at Dallas.
Proceedings (Baylor University. Medical Center)
|January 2, 2015
Summary
Diagnosing placenta percreta is challenging, as illustrated by a case where ultrasound and MRI findings conflicted. This rare condition, placenta percreta, was confirmed after a uterine rupture during delivery.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Diagnostic Imaging
Background:
- Placenta percreta, a rare placental abnormality, poses significant diagnostic and management challenges.
- Early and accurate diagnosis is crucial for preventing severe maternal morbidity.
Observation:
- A 41-year-old woman at 21 weeks' gestation presented with intraabdominal bleeding.
- Initial ultrasound showed no placental abnormality, complicating diagnosis.
- Discrepancies between ultrasound and magnetic resonance imaging (MRI) findings hindered definitive diagnosis.
Findings:
- The patient experienced spontaneous resolution of bleeding after transfusion and was hospitalized.
- Delivery occurred via scheduled cesarean at 34 weeks' gestation.
- Complete uterine fundal rupture occurred during delivery, confirming placenta percreta histologically.
Implications:
- This case highlights the diagnostic difficulties in placenta percreta, even with advanced imaging.
- It underscores the importance of considering placenta percreta in cases of unexplained bleeding.
- Management requires a high index of suspicion and multidisciplinary care to ensure maternal safety.
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