1. PLACENTA PÉRCRETA, CASE REPORT.
- Author
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Garcia, Laura Bonilla, Vico, I., Revelles, L., Pérez, J., Barranco, M., and Puertas, A.
- Subjects
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CONFERENCES & conventions , *LABOR complications (Obstetrics) , *PLACENTA diseases , *FETAL development - Abstract
A 34-year-old woman at 31+5 gestacional week (GW) comes to emergency because she had broken the membranes. Ultrasonography revealed placenta previa anterior, lacunar spaces and uterine myometrial deficiency between the placenta and bladder wall.The Doppler and RMI showed feeding vessels and hipervascularity of the uterine-bladder interface. The case was discussed and the decision was to perform an ultrasound evaluating fetal growth and lung maturation and according to these propose the ideal moment for the end. The cesarean section was planned for 32+3 GW. At that time, laparotomy, revealed large blood vessels and placental penetration through the anterior uterine wall and determined that separating the bladder would be extremely difficult. It was performed a vertical uterine incision to avoid the placental, and successfully delivered a healthy female infant. Hysterectomy was dismissed because of the high risk of bleeding. After the cesarean, she was subjected to an embolization of the hypogastric arteries Post-surgical follow-up were performed analytic controls, ultrasound and RMI. A month after, the patient was discharged, continuing with outpatient controls. Five days later she comes to the control referring abdominal pain, 38,5ºC and oliguria reason why, decides admission and 3 days later, due to worsening and a CAT with signs of abscessing at the uterine, it was decided to perform total abdominal hysterectomy.The surgery confirmed the presence of an abscessed. The results of the cultures taken at surgery reported E.coli infection. The postoperative course was favorable. PP is the most severe variant of placenta accreta. The standard treatment for PP is cesarean hysterectomy; however, some surgeons choose conservative management to avoid potential intraoperative complications. Although conservative management can avoid maternal morbidity, several complications, including sepsis, intravascular coagulation, massive hemorrhage, and delayed hysterectomy, have been reported. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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