Sudden Death due to Uterine Rupture in a Primigravida with Placenta Accreta in Unscarred Uterus: An Autopsy Report

Spontaneous rupture of uterus during pregnancy is a known complication of placenta accreta. Some of the known risk factors for the trophoblastic invasion of the uterine wall leading to placenta accreta during pregnancy are multi-parity, previously scarred uterus, etc. The clinical management of such cases is found in scientific literature; however sudden death due to uterine rupture as a complication of placenta accreta, in a primigravida is not reported till date. We encountered a case, where a 27 year old primigravida, at 29th week of gestation who had no known risk factors, succumbed to death, due to spontaneous uterine rupture. The diagnosis of placenta accreta in this case could be made, only during the autopsy. The clinical presentation and the autopsy findings are discussed in this paper, with a note on diagnostic difficulties, especially in the developing countries.