Sánchez-García BF, Corona-Gutiérrez AA, Sánchez-Peña R, Panduro-Barón JG, Barrios-Prieto E, González-Moreno J

Language: Spanish
References: 15
Page: 239-244
PDF size: 571.95 Kb.

ABSTRACT

Placenta acrreta is a complication of pregnancy that leads to excessive bleeding following birth increasing maternal morbidity and mortality. This study was performed in order to document frequency, predetermining factors and complications of this disease.
Materials and methods: This is an observational, descriptive and transversal study made by the Gynecology and obstetrics department in Juan I. Menchaca Civil Hospital in Guadalajara from 2008 to 2010. A total of 38 patients diagnosed with placenta accrete were included in the study, and statistical data such as age, number of pregnancies, history of previous c-sections, uterine curettage, presence of ongoing placental abruption, type of surgery (procedure performed), surgical time, estimated bleeding, complications (Bladder, urethral or intestinal lesions), transfusions (blood derivatives), admission to an intensive care unit, number of days hospitalized, re – interventions and maternal death.
Data was compiled in a questionnaire sheet, then to a Microsoft Excel page then analyzed with descriptive statistics methods such as central tendency and dispersion measurements: range, median, frequency and percentages. Results were presented in a graphic and comparative form in order to illustrate.
Results: Average age was 28 years, 27 patients live in the metropolitan area of Guadalajara, 18 patients (43.7%) had four or more pregnancies, and all of the patients had a history of at least one cesarean section. 36 patients (94.7%) had a history of placental abruption diagnosed by ultrasound. Gestational age at diagnosis averaged 33 weeks, end of pregnancy 35 weeks. Cesarean section followed by hysterectomy was performed in most patients (89.7%) with an average surgical time of 2 hours and 53 minutes. Average estimated bleeding 2547 ml. Blood transfusions were necessary in 30 patients (78.9%), even though 24 patients (63.1%) presented no complications. The most frequent complications which 14 patients presented were re – interventions and urinary lesions. 12 patients were admitted to the Intensive Care Unit, with an average in hospital time of 7 days with no maternal deaths.
Conclusions: Incidence of placenta accreta was 1 for 642 births, being predetermining factors the presence of previous placental abruption, multiple pregnancies, and more than one previous cesarean sections. A multi–disciplinary intervention was done resulting in better patient prognosis.

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