ABSTRACT
Placental acretism is the abnormal adherence beyond the underlying of the uterine muscle. The penetration of the serous is known as placenta percreta.
The following is a clinical study of a 28 year old woman, who had undergone 2 previous C-Sections, who had been admitted to the hospital previously with ultrasounds suggestive of placental acretism. The magnetic resonance show with severe infiltration of the myometrium in the anterior and lateral right, extending until the mesentery of the abdomen, top of the bladder and the proximal portion of the urethra as well as the soft tissue of the perinea.
Cesarean section was performed at 35 weeks of gestation, once the complete protocol of the placenta previa, had been completed. The placentary tissue invaded the bladder, wide ligament along the entire right side and the posterior pelvis. A hysterectomy was performed in the fundic region, resulting in a live birth, and no complications for the patients. Later an obstetric hysterectomy was performed.
It is important to note the exemplary work of the gynecologist, surgeon, urologist, anesthesiologist, neonatal specialist, hematologist and intensive care workers, working together for a common goal: avoiding the morbidity and mortality of the mother and child.
Key words: Placenta percreta, bladder, ureter, abdominal wall.
RÉSUMÉ
Nous rapportons le cas d’un 28 ans avec deux césariennes précédentes, qui sont venus à l’hôpital avec un diagnostic sur un total de placenta praevia et les données échographiques évocateurs de placenta accreta. L’IRM a montré un placenta percreta sévère avec une infiltration du myomètre en face avant et droit, avec l’extension de la mésentère de l’abdomen, le toit de la vessie et de la partie proximale de l’urètre et les tissus mous du périnée. La césarienne a été réalisée à 35 semaines de gestation, après avoir terminé le protocole d’étude de placenta praevia. Tissu placentaire a pris la vessie, le ligament large dans toute son épaisseur cavité pelvienne droite et dans le cul de sac postérieur. Hystérectomie classique a été réalisée région fundique, produit direct a été obtenue sans complications. Le travail interdisciplinaire entre l’obstétricien, anesthésiste, urologue, radiologue, hématologue et intensiviste éviter la morbidité et la mortalité de la mère et le fils.
Mots-clés: placenta percreta, de la vessie, les uretères, la paroi abdominale.
RESUMO
Relatamos o caso de um de 28 anos com duas cesáreas anteriores, que vieram para o hospital com um diagnóstico de placenta prévia total e os dados ultrassonográficos sugestivos de placenta acreta. A ressonância magnética mostraram uma placenta percreta com infiltração severa do miométrio do lado da frente e para a direita, com a extensão do mesentério do abdómen, o telhado da bexiga e da porção proximal da uretra e dos tecidos moles do períneo. A cesárea foi realizada com 35 semanas de gestação, após a conclusão do protocolo do estudo de placenta prévia. Tecido placentário levou a bexiga, o ligamento largo em toda a sua espessura cavidade pélvica direita e no fundo de saco posterior. Histerectomia clássico foi realizado região fúndica; produto ao vivo foi obtida sem complicações. O trabalho interdisciplinar entre o obstetra, anestesista, médico urologista, radiologista, hematologista e intensivista evitado a morbidade ea mortalidade de mãe e filho.
Palavras-chave: placenta percreta, bexiga, ureter, parede abdominal.
