[Placenta percreta with bladder and rectum invasion]. / Percretismo placentario con invasión de vejiga y recto.
Cir Cir
; 85(1): 66-69, 2017.
Article
em Es
| MEDLINE
| ID: mdl-26832818
BACKGROUND: Placenta percreta may lead to massive obstetric haemorrhage, haemodynamic decompensation, and ultimately death. Total obstetric hysterectomy is universally accepted as treatment; however, the emergence of new techniques such as the uterine artery angioembolisation approach, and the use of chemotherapy agents such as methotrexate, are alternatives also described in the literature. CLINICAL CASE: A 28 year-old patient, in her fourth gestation, with a previous history of 2 vaginal and 1 caesarean birth 4, in her 28.4 week of pregnancy, by second trimester ultrasound, was diagnosed with placenta percreta with bladder and rectal invasion using magnetic resonance imaging. Multidisciplinary and sequential treatment included: Caesarean with placenta in situ, uterine artery embolisation immediately after caesarean, chemotherapy with methotrexate weekly for 4 doses, and finally obstetric hysterectomy after bilateral hypogastric artery ligation. The outcome was favourable and the patient was discharged in good general condition. CONCLUSIONS: The protocoled and sequential management including selective embolization immediately after caesarean section with placenta in situ, weekly chemotherapy with methotrexate and obstetric hysterectomy, preceded by bilateral ligation of the hypogastric arteries, is a therapeutic alternative to be considered in cases of placenta percreta.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Placenta Acreta
/
Reto
/
Bexiga Urinária
Tipo de estudo:
Etiology_studies
/
Guideline
Limite:
Adult
/
Female
/
Humans
/
Pregnancy
Idioma:
Es
Revista:
Cir Cir
Ano de publicação:
2017
Tipo de documento:
Article
País de publicação:
México