Unusual Presentation of Preterm Uterine Rupture; Placenta Accreta- Three Case Reports

We herein report three cases of preterm uterine ruptures. The etiology of ruptures was placenta accreta in various forms like; placenta increta and percreta. All cases presented with abdominal pain and vaginal discharge. Though uterine rupture secondary to adherent placentation had been observed in multiparous women with previous history of cesarean sections, myomectomy, dilatation and curettage and infection, in this series a primigravida without any previous associated risks had uterine rupture at 26 weeks gestation due to placenta increta. All patients’ undergone hysterectomy as life saving procedure. No post op morbidity was observed. Only one baby survived out of three cases. Placenta accreta should be included in the differential diagnosis when a gravida presents with acute abdomen and vaginal discharge and early diagnosis with timely decision for laparotomy followed by hysterectomy can lead to successful management. A low resource country where modern techniques like uterine emboli is not available or not affordable , hysterectomy is a way out option for life saving procedure in placenta accreta.