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Maternal and fetal death at 22 weeks following uterine rupture at the site of the placenta percreta in a C-section scar

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Abstract

Placenta percreta is the abnormal invasion of the placenta through the myometrium and serosa of the uterus. It is the most invasive of the placenta accreta spectrum followed by placenta increta. This paper presents a case of a maternal and fetal death in the second trimester due to rupture of the uterus at the site of placenta percreta in a C-section scar. Postmortem MRI showed a large hemoperitoneum and thinning of the anterolateral uterine wall. Internal examination revealed two liters of blood in the abdomen and rupture of the anterolateral uterine wall at the site of placenta percreta in a previous C-section scar. Placenta percreta is a rare complication of pregnancy, however, it is becoming more common with the increasing rate of C-section, the most common and significant risk factor.

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Acknowledgements

Special thanks to Dr. Michael Pickup, Dawn Thorpe, Jennifer Clement, Maureen Currie, Yolanda Nerkowski, and Andy King for their contributions to post-mortem imaging and photography.

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Authors and Affiliations

  1. Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada

    Lucy M. Bradley

  2. Calgary Laboratory Services, Calgary, AB, Canada

    Lucy M. Bradley

  3. Department of Medical Imaging, University of Toronto, Toronto, ON, Canada

    Jamil A. K. Addas

  4. Ontario Forensic Pathology Service, Forensic Services and Coroners Complex, 25 Morton Shulman Avenue, Toronto, ON, M3M 0B1, Canada

    Jayantha C. Herath

  5. Department of Pathobiology, Toronto, ON, Canada

    Jayantha C. Herath

  6. Laboratory Medicine of University of Toronto, Toronto, ON, Canada

    Jayantha C. Herath

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  1. Lucy M. Bradley
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  2. Jamil A. K. Addas
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  3. Jayantha C. Herath
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Correspondence to Jayantha C. Herath.

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Bradley, L.M., Addas, J.A.K. & Herath, J.C. Maternal and fetal death at 22 weeks following uterine rupture at the site of the placenta percreta in a C-section scar. Forensic Sci Med Pathol 15, 658–662 (2019). https://doi.org/10.1007/s12024-019-00130-5

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  • DOI: https://doi.org/10.1007/s12024-019-00130-5

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