Placenta Percreta in a Gravid Bicornuate Unicollis Uterus
Background. Identifying bicornuate uterus can be challenging especially as a cause of early pregnancy bleeding. On ultrasonographic examination, it is difficult to misdiagnose pregnancy in a bicornuate uterus as an ectopic pregnancy due to the continuity of the endometrium. A rudimentary horn of a b...
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Wiley
2017-01-01
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| Series: | Case Reports in Obstetrics and Gynecology |
| Online Access: | http://dx.doi.org/10.1155/2017/4082182 |
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| author | Sammy Ngichabe Mandeep Sura |
| author_facet | Sammy Ngichabe Mandeep Sura |
| author_sort | Sammy Ngichabe |
| collection | DOAJ |
| description | Background. Identifying bicornuate uterus can be challenging especially as a cause of early pregnancy bleeding. On ultrasonographic examination, it is difficult to misdiagnose pregnancy in a bicornuate uterus as an ectopic pregnancy due to the continuity of the endometrium. A rudimentary horn of a bicornuate uterus in early pregnancy can occasionally be misdiagnosed for an ectopic pregnancy especially when compounded by severe abdominal pains and supportive sonographic evidence. Myometrial invasive grading of placenta may be necessary for emergency preparedness and consenting. Hemihysterectomy is lifesaving when percreta has caused severe postpartum haemorrhage. Case Presentation. We present a 24-year-old primigravida who presented to the maternity department with severe abdominal pains at 35 weeks. She was pale on clinical examination and haemodynamically unstable. She underwent emergency caesarean section with a preoperative diagnosis of concealed abruptio placentae. Intraoperatively we encountered a bicornuate uterus, delivered a fresh stillbirth, and noted a placenta percreta. A hemihysterectomy was done and she recovered after transfusion without complications. Conclusion. A gravid horn of a bicornuate uterus may present as an ectopic pregnancy; careful assessment at laparotomy or laparoscopy is required to prevent inadvertent surgical termination of pregnancy. Placental myometrial invasive assessment is important for delivery emergency preparedness. |
| format | Article |
| id | doaj-art-b1a3e368969b4ff799a2646924dcb8c7 |
| institution | Kabale University |
| issn | 2090-6684 2090-6692 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Obstetrics and Gynecology |
| spelling | doaj-art-b1a3e368969b4ff799a2646924dcb8c72025-02-03T06:44:28ZengWileyCase Reports in Obstetrics and Gynecology2090-66842090-66922017-01-01201710.1155/2017/40821824082182Placenta Percreta in a Gravid Bicornuate Unicollis UterusSammy Ngichabe0Mandeep Sura1Nairobi Women’s Hospital, Nairobi, KenyaUniversity of Nairobi, Nairobi, KenyaBackground. Identifying bicornuate uterus can be challenging especially as a cause of early pregnancy bleeding. On ultrasonographic examination, it is difficult to misdiagnose pregnancy in a bicornuate uterus as an ectopic pregnancy due to the continuity of the endometrium. A rudimentary horn of a bicornuate uterus in early pregnancy can occasionally be misdiagnosed for an ectopic pregnancy especially when compounded by severe abdominal pains and supportive sonographic evidence. Myometrial invasive grading of placenta may be necessary for emergency preparedness and consenting. Hemihysterectomy is lifesaving when percreta has caused severe postpartum haemorrhage. Case Presentation. We present a 24-year-old primigravida who presented to the maternity department with severe abdominal pains at 35 weeks. She was pale on clinical examination and haemodynamically unstable. She underwent emergency caesarean section with a preoperative diagnosis of concealed abruptio placentae. Intraoperatively we encountered a bicornuate uterus, delivered a fresh stillbirth, and noted a placenta percreta. A hemihysterectomy was done and she recovered after transfusion without complications. Conclusion. A gravid horn of a bicornuate uterus may present as an ectopic pregnancy; careful assessment at laparotomy or laparoscopy is required to prevent inadvertent surgical termination of pregnancy. Placental myometrial invasive assessment is important for delivery emergency preparedness.http://dx.doi.org/10.1155/2017/4082182 |
| spellingShingle | Sammy Ngichabe Mandeep Sura Placenta Percreta in a Gravid Bicornuate Unicollis Uterus Case Reports in Obstetrics and Gynecology |
| title | Placenta Percreta in a Gravid Bicornuate Unicollis Uterus |
| title_full | Placenta Percreta in a Gravid Bicornuate Unicollis Uterus |
| title_fullStr | Placenta Percreta in a Gravid Bicornuate Unicollis Uterus |
| title_full_unstemmed | Placenta Percreta in a Gravid Bicornuate Unicollis Uterus |
| title_short | Placenta Percreta in a Gravid Bicornuate Unicollis Uterus |
| title_sort | placenta percreta in a gravid bicornuate unicollis uterus |
| url | http://dx.doi.org/10.1155/2017/4082182 |
| work_keys_str_mv | AT sammyngichabe placentapercretainagravidbicornuateunicollisuterus AT mandeepsura placentapercretainagravidbicornuateunicollisuterus |