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Federación Mexicana de Ginecología y Obstetricia, A.C.

2020, Number 07

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Ginecol Obstet Mex 2020; 88 (07)

Treatment of patients with abnormally attached placenta, with hemorrhage. Systematic review

Villagómez-Mendoza EA, Reyes-López C, Orozco-Gutiérrez I, Martínez-Meraz M

Language: Spanish
References: 34
Page: 458-470
PDF size: 234.04 Kb.


ABSTRACT

Objective: Report the surgical evidence available in the current literature about the medical behavior to be followed in patients with abnormally attached placenta in pregnancies older than 20 weeks, according to blood loss that correlates with maternal morbidity and mortality.
Methodology: Systematic review of the literature available on PubMed, Scholar. google.com, Uptodate, SciELO, of articles published in English and Spanish, from 2002 to the present (August 2019), with the following keywords Mesh (Medical Subject Headings ): placenta acreta; previous placenta; uterine repair; Caesarean Hysterectomy; placenta percreta; uterine conservation; uterine compression suture; obstetric hemorrhage; anomalous placentation; abnormally attached placenta. Inclusion criteria: articles of control cases and case series that included pregnant patients with abnormally adhered placental diagnosis and sections of the surgical technique used, the outcome of which is described in the manuscript.
Results: 40 articles were found but only 34 studies were described that described cases with abnormally adhered placental diagnosis and description of the surgical technique used to achieve a decrease in maternal morbidity and mortality, so the different surgical techniques were compared, 9 articles were found with techniques different surgical procedures for the control of obstetric hemorrhage, in 2 of them there was no report of blood loss, useful for this review.
Conclusions: It is shown that the advanced integral vascular technique (VIVA) and that of Bautista are the ones that are best related to a decrease in maternal morbidity and mortality. The search for surgical techniques and strategies to reduce maternal death, due to an abnormally attached placenta and the application and understanding of what is stated here, can contribute to reducing the incidence of fatal outcomes.


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