Placenta Percreta and Incomplete Uterine Rupture after Endometrial Ablation and Tubal Occlusion

Jaden R. Kohn, Edwina Popek, Concepcion R. Diaz-Arrastia, Xiaoming Guan, Alireza A. Shamshirsaz, Michael A. Belfort, Karin A. Fox

Research output: Contribution to journalArticlepeer-review


Endometrial ablation offers symptomatic relief for menorrhagia. Pregnancy after ablation is rare but is often complicated due to pregnancy loss, growth restriction, preterm premature rupture of membranes, preterm delivery, and morbidly adherent placentation, a dangerous complication that can result in hemorrhage, intensive care unit admission, and cesarean hysterectomy. We report a case of pregnancy conceived contemporaneously with endometrial ablation and tubal occlusion. Diagnosis of pregnancy was delayed due to low suspicion. Complications included cervical implantation and placenta percreta, necessitating hysterectomy with the fetus in situ. Intraoperatively, incomplete uterine rupture was noted. Abnormal neovascularization, fibrous adhesions, and anatomical distortion necessitated a complex surgical approach. Women undergoing endometrial ablation must be thoroughly counseled about the serious risks of postablation pregnancy, the need for contraception, and the risk of sterilization failure. Pregnancy should remain in the differential diagnosis for women of reproductive age, regardless of tubal occlusion. Cases of placenta percreta should be referred early to centers of excellence with multidisciplinary teams.

Original languageEnglish (US)
Pages (from-to)e445-e450
JournalAJP Reports
Issue number4
StatePublished - Oct 1 2016
Externally publishedYes


  • bilateral tubal sterilization
  • endometrial ablation
  • morbidly adherent placenta
  • placenta percreta
  • uterine rupture

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology


Dive into the research topics of 'Placenta Percreta and Incomplete Uterine Rupture after Endometrial Ablation and Tubal Occlusion'. Together they form a unique fingerprint.

Cite this