Pregnancy hemoperitoneum and placenta percreta in a patient with previous pelvic irradiation and ovarian failure

Article Abstract:

Pregnancy occurring after previous pelvic radiation therapy has been associated with early labor and delivery, and low-birth-weight infants. A case is presented of a 23-year-old woman who had had muscle cancer at age seven, which was treated with surgery followed by radiation. Although she remained disease-free, she had delayed puberty and abnormal hormone production. She was treated with estrogen and progesterone hormone therapy and did not experience the withdrawal bleeding that can accompany cyclic hormone therapy. Six months after she electively stopped taking the hormone therapy, vaginal bleeding occurred. A viable eight-week-old fetus attached to an unusually thinly lined uterus was detected. The patient spontaneously aborted the fetus at 13 weeks of pregnancy but the placenta was not delivered. This necessitated surgical hysterectomy and removal of one nonfunctioning ovary. A diagnosis of placenta percreta, the abnormal attachment of the placenta deep into the muscle layer of the uterus, was made. The pelvic radiation received by this patient had apparently been sufficient to cause changes in the lining of the uterus and cause ovarian failure. Since many women who have ovarian failure following pelvic radiation are candidates for in vitro fertilization, an assessment of uterine wall thickness may be warranted to avoid abnormal attachment of the placenta. (Consumer Summary produced by Reliance Medical Information, Inc.)

Radiotherapy, Radiation injuries

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Fetal death associated with measles virus infection of the placenta

Article Abstract:

The case report is presented of a fetal death resulting from maternal measles, which is considered to be a rare occurrence. The 28-year-old patient was 23 weeks pregnant when she developed measles; no complications of pregnancy had been observed up to this point. Symptoms included skin eruptions, fever, eye inflammation, sore throat, blisters on the tongue, and breathing difficulties. After 13 days of illness, the patient's symptoms disappeared, but premature labor occurred and the fetus was stillborn. The placenta was found to be abnormal as a result of infection with the measles virus. However, no signs of measles virus were detected in fetal tissue. This is believed to be the first reported case of fetal death due to measles virus infection of the placenta. It is suggested that the stillbirth resulted from severe placental damage, rather than as a direct result of the measles virus infection. (Consumer Summary produced by Reliance Medical Information, Inc.)

Infection, Measles

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Placenta percreta induced uterine rupture and resulted in intraabdominal abortion

Article Abstract:

A 21-year-old woman in the 23rd week of pregnancy complained of acute abdominal pain. The patient arrived at the hospital in shock. Emergency laparotomy, the insertion of a small instrument affixed with a magnifying lens into the abdomen through a small incision, revealed an enormous amount of blood in the abdominal cavity. Hemorrhage was caused by uterine rupture, which had placed the dead fetus in the abdominal cavity. The placenta had invaded the entire wall of the uterus; placenta percreta, or the abnormal adherence of the placenta in the uterine wall, was the cause of the rupture. The placenta and fetal material were removed and the uterine rupture was repaired. The patient's uterus appeared to be normal two months after surgery. This type of rupture in the second trimester of pregnancy is extremely rare.

Case studies, Abnormalities, Uterus, Uterine perforation

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