Placenta percreta presenting as uterine rupture following previous B-Lynch suture

• Published in: BMJ case reports Vol. 14; no. 10; p. e245593
• Main Authors: Saha, Shubhashis, Abraham, Anuja, Raja Navaneethan, Preethi, Abraham, Kavitha
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.10.2021; BMJ Publishing Group
• Subjects: Abdomen; Case Report; Case reports; Fetuses; Hospitals; Hysterectomy; Laparotomy; Pathogenesis; Placenta; Pregnancy; Pregnancy complications; Reproductive health; Scars; Sutures; Uterus; Womens health; India
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2021-245593

Placenta accreta spectrum disorder varies from minimally adherent placenta to deeply invasive placenta. Placenta percreta is a rare cause for uterine rupture and the incidence of morbidly adherent placenta is on the rise due to increase in the rates of caesarean section. We report a case of a 32-year-old, G2P1L1 who presented to us at 27 weeks in a state of haemodynamic shock with intrauterine fetal death. She had a history of prior caesarean section complicated by postpartum haemorrhage requiring B-Lynch suturing. With an initial diagnosis of caesarean scar rupture, she underwent an emergency laparotomy. Intraoperatively, the caesarean scar was found to be intact and uterine fundal rupture with placental protrusion identified. She underwent caesarean hysterectomy and was discharged in a stable condition. The histopathology report confirmed the diagnosis of placenta percreta.