Placenta Percreta Presenting as an Acute Abdomen in Second Trimester of Pregnancy: Case Report from Middle East - Gynecology & Women's Health

Abnormal  Placentation  carries  life-threatening  consequences  to  the  mother.  Placenta  percreta  is  a  rare  complication  of  pregnancy. It occurs mostly in the third trimester and presents with severe postpartum hemorrhage and placenta retention. It is  rare  in  the  second  trimester  of  pregnancy.  Placenta  percreta  is  becoming  more  common  as  cesarean  section  and  other  uterine  surgeries increase. The presence of a uterine scar remains a major risk factor. Clinical presentation is variable with Antepartum hemorrhage is a usual scenario. However, it is usually seen in the third trimester. The presentation here is rare since it occurred in the second trimester rendering clinical suspicion difficult as was evident in the case. We here present a rare presentation of placenta percreta  occurring  in  the  second  trimester  as  an  acute  abdomen  secondary  to  uterine  rupture  and  intraabdominal  hemorrhage. She had a life-saving total hysterectomy and good postoperative recovery period. This might be the first case to be presented from Middle east with such scenario. Careful evaluation of a pregnant lady with an acute abdomen must be done with consideration of
abnormal placentation as a cause, especially in a patient with risk factors for abnormal placentation. 

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