caa a22 4500 44531043X CHVBK 20180317142627.0 cr unu---uuuuu 170323e20111001xx s 000 0 eng 10.1007/s00404-011-1927-5 doi (NATIONALLICENCE)springer-10.1007/s00404-011-1927-5 Spontaneous uterine rupture at the 21st week of gestation caused by placenta percreta [Elektronische Daten] [Amadeus Hornemann, Michael Bohlmann, Klaus Diedrich, Andreas Kavallaris, Sven Kehl, Katharina Kelling, Friederike Hoellen] Purpose: To describe the management of a ruptured uterus caused by placenta percreta in the 21st week of gestation. Methods: We present a case report of a 33-year-old patient with a ruptured uterus in the 21st week of gestation who presented at the Department of Gynecology and Obstetrics, University of Schleswig-Holstein, Campus Luebeck. Therapeutic management was performed by laparoscopy, and consecutive laparotomy and hysterectomy. Results: A 33-year-old patient presented with severe abdominal pain in the 21st week of gestation at the department of abdominal surgery. A laparoscopy was performed to exclude appendicitis. There was about one liter of blood in the peritoneal cavity and a small, bleeding lesion in the fundus uteri was found which was coagulated. The blood was evacuated and the patient returned to department of gynecology. One hour after the first operation, the patient developed signs of hypovolemic shock and ultrasound showed absent fetal heart beat. An immediate laparotomy was performed and a ruptured uterus was detected. The fetus was removed and a hysterectomy performed. Pathology results showed a placenta percreta. After a few days in hospital and transfusion of 4 liters of blood the patient was discharged in a healthy condition. Conclusions: In a pregnant woman with severe abdominal pain even in the 21st week of gestation a placenta percreta has to be considered as a differential diagnosis. If there is no evidence of other causes, laparoscopy may help to confirm the diagnosis and hysterectomy is a life saving intervention. Springer-Verlag, 2011 Placenta percreta nationallicence Pregnancy nationallicence Uterine rupture nationallicence Acute abdomen nationallicence Hornemann Amadeus Department of Obstetrics and Gynecology, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany aut Bohlmann Michael Department of Obstetrics and Gynecology, University of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany aut Diedrich Klaus Department of Obstetrics and Gynecology, University of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany aut Kavallaris Andreas Department of Obstetrics and Gynecology, University of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany aut Kehl Sven Department of Obstetrics and Gynecology, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany aut Kelling Katharina Department of Obstetrics and Gynecology, University of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany aut Hoellen Friederike Department of Obstetrics and Gynecology, University of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany aut Archives of Gynecology and Obstetrics Springer-Verlag 284/4(2011-10-01), 875-878 0932-0067 284:4<875 2011 284 404 https://doi.org/10.1007/s00404-011-1927-5 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00404-011-1927-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Hornemann Amadeus Department of Obstetrics and Gynecology, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany aut NATIONALLICENCE 700 1- Bohlmann Michael Department of Obstetrics and Gynecology, University of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany aut NATIONALLICENCE 700 1- Diedrich Klaus Department of Obstetrics and Gynecology, University of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany aut NATIONALLICENCE 700 1- Kavallaris Andreas Department of Obstetrics and Gynecology, University of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany aut NATIONALLICENCE 700 1- Kehl Sven Department of Obstetrics and Gynecology, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany aut NATIONALLICENCE 700 1- Kelling Katharina Department of Obstetrics and Gynecology, University of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany aut NATIONALLICENCE 700 1- Hoellen Friederike Department of Obstetrics and Gynecology, University of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany aut NATIONALLICENCE 773 0- Archives of Gynecology and Obstetrics Springer-Verlag 284/4(2011-10-01), 875-878 0932-0067 284:4<875 2011 284 404 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer