Spontaneous rupture of primigravid uterus due to morbidly adherent placenta.

Morbidly adherent placenta in a nulliparous woman is a rare phenomenon. An unusual case of a 20 years old primigravida presented in emergency with unstable haemodynamics and abdominal pain at 17 weeks of gestation is reported. She was found to have complete placental invasion and haemoperitoneum on laparotomy. Although there is an increased risk of placental invasion (increta and percreta) causing uterine rupture in previous cesareans but morbid adhesion resulting in placenta percreta without previous uterine surgery is a rarity. Exact pathogenesis is still unknown. Prenatal diagnosis with the help of Doppler ultrasound and MRI is important to reduce both fetal and maternal morbidity and mortality.