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Placenta Percreta in First Trimester Leading to Disseminated Intravascular Coagulopathy (DIC): A Rare Case Report
Charu Lata Bansal1, Jyotsana Gupta2, Deepti Asthana1
1Senior Resident, Department of Obstetrics and Gynecology, Gangauri Hospital, SMS Medical College , Jaipur, India .
Placenta percreta is the most severe form of abnormal placental attachment. It is a variant of placenta accreta in which chorionic villi penetrate the entire thickness of the myometrium through the uterine serosa and may involve the adjacent structures. Literature review shows very few cases encountered during the first trimester of pregnancy. A-20-year-old woman with previous one cesarean section presented with continuous vaginal bleeding beginning after incomplete abortion at seven weeks and six days period of gestation for which she underwent dilatation and curettage. MRI revealed irregular heterogeneous signal intensity mass with large area of hemorrhage in lower anterior wall extending towards the endometrial cavity suggestive of morbid adherent placenta. Following continuous bleeding after repeated curettage for retained, adherent placenta her coagulation profile got deranged and DIC developed. Correction of coagulopathy and emergency hysterectomy as a life saving measure for placenta percreta was done in our case.
Placenta percreta is the most severe form of abnormal placental attachment. It is a variant of placenta accreta in which chorionic villi penetrate the entire thickness of the myometrium through the uterine serosa and may involve the adjacent structures. Literature review shows very few cases encountered during the first trimester of pregnancy. A-20-year-old woman with previous one cesarean section presented with continuous vaginal bleeding beginning after incomplete abortion at seven weeks and six days period of gestation for which she underwent dilatation and curettage. MRI revealed irregular heterogeneous signal intensity mass with large area of hemorrhage in lower anterior wall extending towards the endometrial cavity suggestive of morbid adherent placenta. Following continuous bleeding after repeated curettage for retained, adherent placenta her coagulation profile got deranged and DIC developed. Correction of coagulopathy and emergency hysterectomy as a life saving measure for placenta percreta was done in our case.
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