Spontaneous Uterine Rupture due to Placenta Percreta in Second Trimester of Pregnancy: A Case Report

Spontaneous uterine rupture due to placenta percreta in the second trimester is extremely rare and difficult to manage. A 26-year old pregnant woman at 27 gestational weeks with a history of two previous cesarean sections admitted to our center because of abdominal pain and vaginal bleeding. Ultrasound examination revealed placenta previa with moderate amount of intraperitoneal fluid. The border between myometrium and placenta was not differentiated. Paracentesis under ultrasound guidance showed bloody fluid. On emergency laparotomy, there was 1500 ml of blood in the peritoneal cavity and placenta was protruding through a bleeding full thickness uterine defect. Hemorrhage was controlled by transfusion of blood products and conservative surgery. The patient was discharged on the 3th day after surgery without complications. Placenta percreta induced spontaneous uterine rupture should be taken into consideration in pregnant women who have abdominal pain and intraperitoneal fluid.