Acretismo Placentario

Abstract

Placenta accreta is a broad term that encompasses the conditions in which the placenta, in histopathological terms, can be accreta, increta or percreta. Being able to distinguish between these entities in clinical situations, is not easy. It remains a challenge even after diagnosis, except when the uterus is removed and subjected to pathological examination. Percreta placenta is the most serious placentas for their great invasion, and is associated with high maternal morbidity compared with other varieties.

The case of a patient of 36 years old with a history of antiphospholipid antibodies and stillbirths syndrome occurs, is in her sixth pregnancy of 28.6 weeks and is diagnosed sonographically total occlusive placenta previa and placenta accreta. It is particularly treated with heparin and low molecular weight ASA. Prior to admission, heavy bleeding genital glittering red so it is transferred to Provincial Teaching Hospital Ambato, where diagnoses are confirmed. She underwent emergency caesarean with pregnancy diagnostics 28.6 weeks + Total occlusive placenta previa bleeding + antiphospholipid antibody síndrome + accretism + anticoagulated patient. As a complication of surgery percreta placenta is seen to vegija invasion, parametrial and cervix, so the total obstetric hysterectomy is performed without adnexectomy; hallo posteriormene is complicating bilateral ureteral ligation developing acute renal failure. Therefore it was necessary bilateral ureteral reimplantation, which yields box renal failure, and patient evolves favorably