Placenta Percreta presenting with hypovolumic shock at early gestation: A rare case report

      Author: Dr Asma Mukhtar, Co. Author: Dr.Maimona Riaz

            POf Hospital Wah Cantt. Pakistan

 

Introduction

Abnormal placental localization occurs as a defective interaction between decidual layer and placenta.  The first case reported in history by Plater in 1958 in modern literture . The incidence is upto 1 in 2500.  With the increase in number of cesarean section the risk increases more upto 10 % at 4 or more. The placenta percreta presents with uterine rupture in late 2^nd and 3^rd trimester but it is very rare when presents with uterine rupture in late 1^st and early 2^nd trimester. When morbid adherent placentas are dignosed at the gestation before viability, counseling of patient should be done to terminate pregnancy to avoid mortality and morbidity. Guidelines should be made for localization and sonographic examination of placental localization in early 2^nd trimester.  Planned hysterectomy with involvement of MDT is important to assess surrounding structures integrity to avoid post operative complications including bowel and bladder.