Conservative Management of Spontaneous Uterine Perforation Associated with Placenta Accreta: A Case Report

Robert B. Gherman, Ernest G. Lockrow, Donald J. Flemming, Andrew J. Satin

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Placenta accreta occurring in an unscarred uterus is exceedingly rare. Previous cases of spontaneous uterine perforation associated with placenta accreta were treated with hysterectomy. CASE: A nulliparous woman was clinically diagnosed with placenta accreta when spontaneous vaginal delivery was complicated by postpartum hemorrhage and a retained placenta. Magnetic resonance imaging subsequently revealed focal areas of placenta accreta. Acute-onset abdominal pain and culde-sac fluid prompted diagnostic laparoscopy, which revealed a spontaneous uterine perforation in the right posterior-lateral aspect of the uterus. This area was oversewn, and the patient received 2 weeks of postoperative antibiotics because of Enterococcus faecalis bacteremia. CONCLUSION: Spontaneous uterine perforation associated with placenta accreta can be managed conservatively.

Original languageEnglish (US)
Pages (from-to)210-213
Number of pages4
JournalJournal of Reproductive Medicine for the Obstetrician and Gynecologist
Volume49
Issue number3
StatePublished - Mar 1 2004
Externally publishedYes

Keywords

  • Placenta accreta
  • Reproduction techniques
  • Uterine perforation

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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