CONSERVATIVE MANAGEMENT OF SPONTANEOUS UTERINE PERFORATION IN CASE OF PLACENTA ACCRETA DURING CAESAREAN SECTION: CASE REPORT
English

Neha Patel, Jayun M. Joshi, Raxita Patel, Yamini Trivedi
2013 Journal of Evolution of Medical and Dental Sciences  
BACKGROUND: The incidence of placenta accrete has increased 10 fold in the past 50 years and now occurs with a frequency of 1 per 2,500 deliveries. Women who have had 2 or more cesarean deliveries with anterior or central placenta previa have nearly a 40% risk of developing placenta accreta. An abnormally adherent placenta, although an uncommon condition, assumes considerable significance clinically because of morbidity and at times mortality from severe hemorrhage, uterine perforation, and
more » ... erforation, and infection. Placenta accrete occurring in an unscarred uterus is exceedingly rare. CASE PRESENTATION: A 25 year-old multigravida was admitted for emergency Caesarean Section at 36 weeks with the diagnosis of preeclampsia. There were 2 small uterine perforations seen on posterior wall of uterus. The placenta was found to be densely adherent to the posterior uterine wall. Piecemeal excision of the placenta as close as possible to the uterine lining was then performed. The perforations were sutured with interrupted stitches. CONCLUSION: Spontaneous uterine perforation associated with placenta accreta can be managed conservatively with suturing & does not necessitate hysterectomy.
doi:10.14260/jemds/338 fatcat:smzb6uiihjchdcfe3bfk4uq4ja