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ISSN 2448-8720 (Print)
Organo Oficial de la Secretaria de Salud de Quintana Roo

2018, Number 39

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Salud Quintana Roo 2018; 11 (39)

Placenta accreta without previous caesarean section

Narváez-Palacio J, Cárdenas-Núñez RC, Macías-Gil A, González-Suárez A, Baqueiro-Canto R, Padrón-Arredondo G

Language: Spanish
References: 27
Page: 21-24
PDF size: 638.04 Kb.


ABSTRACT

Introduction. The first described case of placenta accreta was in 1889 by Ahlfeld, in 1897 Weisse performed the first successful vaginal hysterectomy, and in 1900 Alexandroff performed the first vaginal hysterectomy for placenta accreta.
Clinical case. A 39-year-old woman with a pregnancy of 38.5 weeks gestation, no labor and total placenta previa. Gesta five and three vaginal births. Normal maternal and fetal vital signs. Ultrasound reported: single cephalic, longitudinal product with placenta completely covering the cervical orifice. Total anterior body placenta, at the level of the lower third of the vesicouterine fold; myometrium very thinned, loss of myometrio-trophoblastic interface; at the level of the closed internal orifice (adjacent to the accretion site) hypervascularized cervix with the appearance of a honeycomb; amniotic fluid ILA 9.6, maximum group 3.85 cm, PFE 2.957 g, P21, fetometry 36.4 weeks gestation. Nuclear magnetic resonance reported: hypointense placenta in T2 with well-defined total preface, no apparent infiltration to adjacent regions, hyperintense bladder in well-defined T2 and no contour defects. A Kerr caesarean section was performed, plus a total abdominal hysterectomy with double placement of the J catheter by cystoscopy. The patient was discharged without complications.
Conclusion. Haghenbeck reports that the prevalence of this nosological entity was 1 case for every 533 pregnancies between 1982 and 2002. Due to the current increase in caesarean sections, the number of cases is expected to increase.


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