000			02288nam a22001937a 4500
999			_c10233 _d10233
003			PILC
005			20240720152932.0
008			171019b xxu||||| |||| 00| 0 eng d
040			_cFEU-NRMF MEDICAL LIBRARY
041			_aENGLISH
050			_aRESOB20160004
100			_aWanasen, Samantha Quennie D., M.D.
245			_aPlacenta Induced Third Trimester Uterine Rupture in an Unscarred Uterus: A Diagnostic Dilemma
260			_aQUEZON CITY _bFEU-NRMF _c2016
300			_aNO PAGES
520			_aABSTRACT: Cases of urine rupture induced by a percreta in an unscarred uterus are rare. This is a case of 30 year old, Gravida 2 Para 1 (1001) Pregnancy Uterine 31 Weeks and 2 days age of gestation with persistent generalized abdominal pain found out to have uterine rupture secondary to placenta percreta. This paper aims to discuss the differential diagnoses foe cases of third trimester abdominal pain, the appropriate diagnostic modalities and the best management for such case. Uterine rupture should be considered in the differential diagnosis in all pregnant women who present with acute abdomen even if there are no risk factors. Exploratory laparotomy was done to investigate the cause of the patient's severe abdominal pain on top of intrauterine fetal bradycardia. During the procedure, uterine rupture with massive bleeding was detected; therefore, subtotal abdominal hysterectomy was performed was discharged without any complications. Pathological analysis of the uterine sspecimen revealed placenta percreta to be the cause of the rupture. In conclusion, uterine rupture should be considered in the differential diagnosis in all pregnant women who present with acute abdomen even if there are no risk factors. Several diagnostic modalities such as ultrasonography and MRI can be helpful in the diagnosis but high index of suspicion and clinical judgment are still if higher value and histopathology in the gold standard for making the final diagnosis of Placenta Percreta. The choice between Hysterectomy or conservative therapy is dependent on the severity of the placenta percreta. Conservative management has a 4-fold increase in mortality rate compared with hysterectomy hence in emergency cases hysterectomy is preferred.
521			_aresearch
942			_2lcc _cRE