Placenta percreta with congenital uterine abnormality in a primigravida: A case report
Abnormal placentation is typically seen in patients with risk factors, usually a history of uterine surgery, and follow up for these cases would be tailored accordingly. This a case of placenta percreta in a primigravida with congenital uterine abnormality noted during surgery. Case Description: A...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | en |
| Published: |
Malaysian Medical Association
2021
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| Subjects: | |
| Online Access: | http://ir.unimas.my/id/eprint/35783/1/placenta1.pdf http://ir.unimas.my/id/eprint/35783/ http://www.e-mjm.org/2021/v76s3/index.html |
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| Summary: | Abnormal placentation is typically seen in patients with risk factors, usually a history of uterine surgery, and
follow up for these cases would be tailored accordingly. This a case of placenta percreta in a primigravida with congenital
uterine abnormality noted during surgery. Case Description: A 41-year-old primigravida with gestational diabetes mellitus on
metformin presented at 20 weeks of pregnancy with acute abdomen without per vaginal bleeding. Physical examination
revealed a distended abdomen with generalized tenderness, and bedside scan revealed a viable fetus within uterus with low
lying placenta and some free fluid in the abdomen. She was normotensive but tachycardic, with a hemoglobin of 8 g/dL (her
booking hemoglobin was 11.3 g/dL). Formal ultrasound was reported as perforated appendicitis. Intraoperatively placenta
percreta with uterine rupture was diagnosed, with the entire amniotic sac expelled out. Noted unicornuate uterus with
rudimentary horn; patient did not have left ovary and Fallopian tube. Subtotal abdominal hysterectomy was done. The fetus
did not survive. HPE was reported as placenta percreta with uterine fibroid. Discussion: An online search revealed less than 10
similar cases being reported, and they mostly were of a younger-age group. This patient also had a history of subfertility for 5
years that was not previously investigated. Due to her age factor, she was referred for detailed scan however she presented 2
weeks before her scheduled appointment with the MFM team. Pregnant primigravida in acute abdomen with free fluid should
raise suspicion for possibility of abnormally invasive placenta and congenital uterine abnormality |
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