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Acute abdomen caused by placenta percreta in the second trimester
American Journal of Obstetrics and Gynecology
|July 1, 1987
Summary
Diethylstilbestrol (DES) exposure in utero can lead to rare pregnancy complications. This case highlights placenta percreta causing hemoperitoneum in a DES-exposed patient without prior uterine surgery.
Area of Science:
- Obstetrics and Gynecology
- Reproductive Health
- Maternal-Fetal Medicine
Background:
- Diethylstilbestrol (DES) is a synthetic estrogen previously prescribed to prevent miscarriage.
- In utero DES exposure is associated with various reproductive tract abnormalities in female offspring.
- These abnormalities can increase risks during pregnancy, including those related to the placenta.
Observation:
- A pregnant woman with a history of in utero DES exposure presented with symptoms of an acute abdomen.
- The patient was at 21 weeks' gestation and had no history of uterine surgery.
- Clinical examination revealed hemoperitoneum, indicating bleeding into the abdominal cavity.
Findings:
- The hemoperitoneum was directly associated with placenta percreta, a condition where placental tissue invades the uterine wall.
- This represents a rare and severe obstetric emergency, particularly in the absence of prior uterine surgical procedures.
- The findings underscore the potential long-term reproductive consequences of in utero DES exposure.
Implications:
- This case emphasizes the importance of considering in utero DES exposure when evaluating obstetric complications.
- It highlights the risk of placenta percreta and associated hemoperitoneum in such patients.
- Further research may be warranted to understand the specific mechanisms linking DES exposure to placental invasion and to improve management strategies.