Neyazi Salwa M
Department of Obstetrics and Gynecology, College of Medicine, King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia.
Saudi Med J. 2013 Jul;34(7):753-6.
Placenta percreta is a complication of pregnancy with significant morbidity and mortality rates. Spontaneous uterine rupture in early pregnancy due to placenta percreta is rare. We report a case of this life-threatening complication occurring at the sixteenth week of gestation. The patient presented with signs of shock, acute abdomen, and evidence of hemoperitoneum. The pregnancy was viable with a normal ultrasound appearance that created some confusion and there was a dilemma in the diagnosis of this case. Various obstetric and surgical causes were taken into consideration. The patient was taken to the operating room immediately for exploratory laparotomy. She was found to have fundal uterine rupture, which was managed by uterine repair. This patient had prior cesarean section and dilatation and curettage; factors well known to predispose for placenta percreta. Here, we emphasize the importance of a fast decision and surgical intervention to save a patient's life in cases of uterine rupture.
穿透性胎盘植入是一种妊娠并发症,具有较高的发病率和死亡率。妊娠早期因穿透性胎盘植入导致的自发性子宫破裂较为罕见。我们报告一例发生在妊娠16周时的这种危及生命的并发症病例。患者出现休克体征、急腹症及腹腔内出血迹象。妊娠可存活,超声表现正常,这造成了一些混淆,且该病例的诊断存在两难情况。考虑了各种产科和外科病因。患者立即被送往手术室进行剖腹探查。发现患者子宫底部破裂,通过子宫修复进行处理。该患者既往有剖宫产及刮宫史;这些都是已知的易导致穿透性胎盘植入的因素。在此,我们强调在子宫破裂病例中快速决策和手术干预以挽救患者生命的重要性。