Abstract：
Placenta percreta is a rare, aggressive, and severe form of the placenta accreta spectrum. One of its most devastating effects is the sudden rupture of uterus. Uterine scarring is the leading risk factor for uterine rupture, although it can also happen, but rarely, in an unscarred uterus showing more severe repercussions. The present study reported a case of an Egyptian primigravida female, aged 29 years old, at 32 weeks of gestation who died suddenly due to uterine rupture complicating placenta percreta, the diagnosis of which was first settled during autopsy. There was no history of abdominal trauma. No medical history of significance was present. Autopsy denoted an intrauterine fetal death of 32 weeks gestational age. The fundus of the uterus had a laceration (rupture) of the uterine wall including the serosa and myometrium. The placenta has extensively infiltrated the fundus uterine wall and penetrated the myometrium and serosa. Histopathological examination of the ruptured site on the uterus confirms total invasion of the uterine wall by chorionic villi with the presence of hemorrhage and fibrin indicating placenta percreta. Uterine rupture due to placenta percreta may go unnoticed, especially when no associated high-risk factors exist. The current case depicts that placenta percreta is a rare but critical complication of pregnancy that may exist at any stage of pregnancy without any associated high-risk factors with unusual symptoms and leads to uterine rupture and sudden death.
摘要：
胎盘是一种罕见的，侵略性,和严重的胎盘植入谱。其最具破坏性的影响之一是子宫的突然破裂。子宫瘢痕形成是子宫破裂的主要危险因素,虽然也有可能发生,但很少,在无疤痕的子宫里表现出更严重的影响。本研究报告了一名埃及女性，29岁,在妊娠32周时，由于子宫破裂合并胎盘穿孔而突然死亡，其诊断首先在尸检期间确定。无腹部外伤史。无重大病史。尸检表明宫内胎儿死亡为32周孕龄。子宫底包括浆膜和子宫肌层在内的子宫壁撕裂（破裂）。胎盘已广泛浸润眼底子宫壁，并穿透子宫肌层和浆膜。子宫破裂部位的组织病理学检查证实了绒毛膜绒毛对子宫壁的完全侵袭，存在出血和纤维蛋白指示胎盘。胎盘穿孔引起的子宫破裂可能被忽视，特别是当没有相关的高危因素存在。目前的病例描述了胎盘是一种罕见但严重的妊娠并发症，可能存在于妊娠的任何阶段，没有任何相关的高风险因素，伴有异常症状，并导致子宫破裂和猝死。
