Campos-Bolaños GA, Enríquez-García R, Guerrero-Avendaño G

Language: Spanish
References: 8
Page: 236-240
PDF size: 279.17 Kb.

ABSTRACT

Introduction. Placenta accreta is defined as an abnormal implantation of the placenta on the uterine wall, of varying severity due to the partial or complete absence of the decidua basalis. Diagnosis is achieved by obstetric ultrasound and complemented with application of Doppler and magnetic resonance. The most relevant risk factors are: multiparity, youth, dilation and curettage, and prior cesarean section. Due to the increase in the latter, the number of patients at risk of presenting placenta accreta is greater. It is among the leading causes of obstetric bleeding, mainly in the immediate postpartum, which conditions increased maternal morbidity and mortality due to both the disorder itself and its treatment, which consists of partial or total hysterectomy (the latter most commonly). The objective was to evaluate transoperative behavior with special attention to bleeding and prove its reduction in patients subjected to embolization.
Materials and methods. A retrospective study was conducted in 21 patients with diagnosis of placenta accreta in variable degree, attended in the period between January 2010 and June 2013, of whom 8 were subjected to embolization prior to the surgical event.
Results. To date we have performed eight embolizations in patients with placenta accreta. All the patients included, except 2, were multiparous with prior cesarean sections. The diagnosis was achieved with the aid of ultrasound and application of color Doppler. Embolization was satisfactory in 8 patients, given that they did not present bleeding in puerperium. In hysterectomy the maximum volume of bleeding was 1,800 cm³; however, this occurred in an interval of 3 to 7 days after embolization. In most patients hysterectomy was performed in patients who had had the desired number of children.

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