Embarazo ístmico y acretismo placentario: diagnóstico en I trimestre: caso clínico / Isthmic pregnancy and placental accretism: clinical case
Rev. chil. ultrason
;
15(2): 49-52, 2012. ilus
Article
in Spanish
| LILACS
| ID: lil-712358
ABSTRACT
The diagnosis of placenta accreta is oftenmade during the second half of pregnancy, usually associated with previous placenta. Here we present acase of pregnancy implantation in the uterine isthmus diagnosed during the 8th week of gestation. Among the ultrasound findings to highlight we found isthmic bulging by the gestational sac with fetal heartbeats, empty uterine cavity and cervical canal, absence ofmyometrium along the vesico-uterine septum and posterior signs of early placental accretism. At thirteen weeks dilated vessels and irregularly shaped lacunae with turbulent blood flow were seen in the placenta. Expectant management was made confirming accretism with placenta percreta involving the parametrium and respecting the bladder. Cesarean section with hysterectomy was made at 34th weeks in conjunction with interventional radiology (Vascular ballooning of the internal and common iliac arteries) with good maternal and perinatal outcomes. Pathology analysis confirmed prenatal findings.
RESUMEN
El diagnóstico de acretismo placentario se realiza en la segunda mitad del embarazo, asociado frecuentemente a placenta previa. Presentamos uncaso clínico en el que se observó una implantación ístmica en la semana 8, destacando los signos de abombamiento ístmico global con saco gestacionaly embrión vivo, cavidad corporal uterina vacía, canal cervical vacío, ausencia de miometrio en tabique vesico-uterino y posteriormente signos sugerentes deacretismo en semana 13 con desarrollo de vasculatura subplacentaria y luego lagunas vasculares de flujo turbulento.Se hizo un manejo espectante confirmando durante la evolución signos de acretismo y percretismo miometrial, extenso desarrollo vascular en parametrios y sin invasión vesical. Fue interrumpida con semanas, por cesárea-histerectomía, optimizada con técnica radiológica intervencional (oclusiónvascular intraoperatoria en secuencia de arterias ilíacas internas e íliacas comunes) con buen resultado materno y perinatal. La anatomía patológica confirmó diagnósticos ultrasónicos.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Placenta Accreta
/
Ultrasonography, Prenatal
Type of study:
Diagnostic study
Limits:
Adult
/
Female
/
Humans
/
Infant, Newborn
/
Pregnancy
Language:
Spanish
Journal:
Rev. chil. ultrason
Journal subject:
Diagnostic Imaging
Year:
2012
Type:
Article
Affiliation country:
Chile
Institution/Affiliation country:
Universidad de Chile/CL
/
Universidad de Valparaíso/CL
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