Abstract

A 25-year-old woman, gravida 2, para 1 reported with history of 27 weeks pregnancy with pain abdomen and bleeding per vaginum (PV) of 2 days duration. She had undergone lower segment cesarean section (LSCS), done 3 years back during previous pregnancy. On examination, patient had pallor, tachycardia, and hypotension. The uterus was corresponding to the period of gestation. There was tenderness over left side of uterus and fetal heart sounds were absent. Per speculum examination revealed amniotic fluid leak mixed with blood. Ultrasonography (USG) findings were suggestive of moderate hemoperitoneum. Uterine rupture at the site of the previous LSCS scar was suspected. Patient was taken for emergency laparotomy. Intraoperative, previous cesarean scar was intact with the fetus inside the uterine cavity. There was left cornual implantation of placenta with a rent of about 4 cm. The placenta was protruding outside the uterus at left cornual end. Per-operative diagnosis of placenta percreta leading to uterine rupture was made. Obstetric hysterectomy was performed. The diagnosis of placenta percreta was confirmed later by histopathological examination.

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