Castelazo-Morales E, Monzalbo-Núñez DE, López-Rioja MJ, Castelazo-Alatorre S

Language: Spanish
References: 12
Page: 525-529
PDF size: 164.21 Kb.

ABSTRACT

The evolution of obstetrics has led us to beneficial discoveries, and to new pathologies. The increase of cesarean section is due to elective cesarean section and cesarean section on maternal request, which have increased in popularity over the last past few years. Without condemning them, we have to take into account the benefits, as well as the complications that may arise from them, leading us to pathologies that were not frequent before, such as placental acretism, which today, is the second cause of obstetric hemorrhage worldwide. For us to be able to counteract the potential complications, it is important to have a multidisciplinary team that allows us to decrease maternal and neonatal death, starting with primary prevention, capable of identifying risk factors, so as to be able to make an early diagnosis. Today, imaging studies have described suggestive markers of acretism at early gestational age, such as 8.4 to 14.2 weeks, allowing us a wide range of time for decision making. In the majority of cases, it is required to perform an obstetrical hysterectomy as a definitive treatment, which is a real challenge for medical skills. Nevertheless, conservative treatment with limited evidence, with uterotonics, and uterine artery embolization, has proved useful. When set on a scale, the risks and benefits of an elective, or maternal request cesarean section, we can understand why we have concluded that, in absence of maternal or fetal indications, natural delivery is the best way to resolve pregnancy.

REFERENCES

1. Committee on Obstetric Practice. Committee opinion no. 559: Cesarean Delivery on Maternal Request. Obstet Gynecol 2013;121:904-907.

2. Silver RM, Landon MB, Rouse DJ, et al. Maternal morbidity associated with multiple repeat cesarean deliveries. Obstet Gynecol 2006;107:1226-1232.

3. Wei SQ, Audibert F, Luo ZC, et al. Maternal plasma 25-hydroxyvitamin D levels, angiogenic factors, and preeclampsia. Am J Obstet Gynecol 2013;208:390.e1-6.

4. Lal AK, Nyholm J, Wax J, et al. Resolution of Complete Placenta Previa: Does Prior Cesarean Delivery Matter? J Ultrasound Med 2012;31:577-580.

5. Hull AD, Moore TR. Multiple repeat cesareans and the threat of placenta accreta: incidence, diagnosis and management. Clin Perinatol 2011;38:285-296.

6. Ballas J, Pretorius D, Hull A, et al. Identifying Sonographic Markers for Placenta Accreta in the First Trimester. J Ultrasound Med 2012;31:1835-1841.

7. Committee on Obstetric Practice. Committee opinion no. 529: placenta accreta. Obstet Gynecol 2012;120:207- 211.

8. Al-Serehi A, Mhoyan A, Brown M, et al. Placenta Accreta: an Association with Fibroids and Asherman Syndrome. J Ultrasound Med 2008;27:1623-1628.

9. Dwyer BK, Belogolovkin V, Tran L, et al. Prenatal diagnosis of placenta accreta: sonography or magnetic resonance imaging? J Ultrasound Med 2008;27:1275-1281.

10. Lax A, Prince MR, Mennitt KW, et al. Magn Reson Imaging 2007;25: 87:93.

11. Pacheco LD, Gei AF. Controversies in the management of placenta accreta. Obstet Gynecol Clin N Am 2011;38:313-322.

12. Sentilhes L, Ambroselli C, Kayem G, et al. Maternal outcome after conservative treatment of placenta accreta. Obstet Gynecol 2010;115:526-34.