Placenta increta in the second trimester of pregnancy: report of a case.

A rare case of placenta increta in the second trimester of pregnancy is reported. The patient was at 15 weeks gestation when the pregnancy, which had been complicated by a maternal rubella infection, was terminated at a regional hospital. However, vaginal bleeding persisted after the operation in spite of medication to control bleeding. Curettage of the uterine cavity one month later failed to reveal any retained placental tissue or other pathology. Therefore, an exploratory laparotomy was performed, yet nothing particular was found in the peritoneal cavity. So, the patient was transferred to our department. Sonography revealed a lower uterine mass of 4.0 x 3.3 cm in size. A persistently low serum hCG titer was also found. Placenta accreta was highly suspected. Three doses of methotrexate were given to control bleeding, yet without results. Hysterectomy was finally performed. A histological study revealed placenta increta.