Intra-Abdominal Hemorrhage Induced by Medical Abortion in Mid-Trimester Pregnancy: An Unusual Presentation of Placenta Percreta
Wipada Laosooksathit MD*, Therdkiat Trongwongsa MD**, Amarin Narkwichean MD, PhD*
Affiliation : * Department of Obstetrics and Gynecology, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand ** Department of Pathology, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand
We present a case report of 36-year-old pregnant with intra-abdominal hemorrhage caused by placenta percreta without uterine rupture after medication-induced abortion. Ultrasonography revealed 20-week gestation pregnancy with anterior placenta previa and evidences of the placenta adherens. Surgical exploration was performed twice. The first operation was emergency abdominal exploration. In the second operation, a hysterotomy followed by total abdominal hysterectomy was performed. Massive blood transfusion was required due to 10,000 ml intra-operative blood loss. A review of diagnosis and management of the placenta adherens is also discussed in this report.
Keywords : Placenta percreta, Intra-abdominal hemorrhage, Medical abortion, Mid-trimester pregnancy
