Rotura uterina por placenta percreta. Un caso clínico en útero bicorne unicollis

A woman in the 27th week of gestation, with a prior diagnosis of uterus bicornis unicollis and a cervical cerclage in situ, presented to the emergency department with severe abdominal pain. No uterine dynamics were observed. The patient rapidly deteriorated shortly after admission, warranting removal of the cervical cerclage and emergency cesarean section delivery with the working diagnoses of hypovolemic shock and abruptio placentae. Laparotomy showed free blood in the peritoneum (2 liters) as well as a placenta accreta with a 3-cm perforation in the uterine fundus. A female infant, weighing 1030 g, was delivered and progressed satisfactorily.