ABSTRACT
El acretismo placentario es causa de hemorragia posparto y es una entidad que incrementa considerablemente la morbimortalidad materna. El diagnóstico anteparto es difícil. La embolización selectiva del vaso nutricio es una técnica conservadora que permite preservar el útero, y por lo tanto conservar la fertilidad. Presentamos el caso de una mujer con hemorragia puerperal, en el que se planteó el diagnóstico diferencial entre acretismo focal y malformación arterio-venosa uterina, que se trató exitosamente mediante embolización de arterias uterinas y posterior legrado, preservando fertilidad y consiguiendo nuevo embarazo posteriormente. Se evalúa la importancia de la interpretación de las imágenes para el diagnóstico, y la adaptación individual de los métodos terapéuticos y el manejo multidisciplinar
Placenta accreta can cause postpartum bleeding and has high maternal morbidity and mortality. Prenatal diagnosis is difficult. Selective embolisation of the uterine artery is a conservative technique that preserves the uterus and fertility. We present the case of a woman with puerperal bleeding, with a postulated differential diagnosis of focal placenta accreta and uterine arteriovenous malformation. Uterine artery embolisation and curettage successfully preserved fertility and the patient subsequently conceived again. We discuss the importance of image interpretation for correct diagnosis, the personalised adaptation of therapeutic methods and a multidisciplinary approach
Subject(s)
Humans , Female , Adult , Placenta Accreta/therapy , Uterine Artery Embolization/methods , Postpartum Hemorrhage/etiology , Uterine Artery Embolization/trends , Postpartum Hemorrhage/therapy , Uterine Artery/abnormalities , AngiographyABSTRACT
OBJECTIVES: To describe a case diagnosed with intracranial teratoma in week 32 of gestation, as well as review of the literature in order to discern the appropriate treatment method and general prognosis of this anomaly. METHODS: A literature search was performed on the prenatal diagnosis of congenital intracranial teratomas in MEDLINE, EMBASE, Cochrane library data bases. Evaluated in this review are parameters such as time of prenatal diagnosis, associated pathology, size of tumors, method of terminating pregnancy, perinatal outcome and histological study of the tumor. RESULTS: A total of 49 cases were found, of which 12 were finished gestation, 28 cesarean section was performed and only nine had vaginal delivery. All died in the neonatal period except in three cases with intrauterine death after diagnosis. CONCLUSION: As the incidence of intracranial immature teratomas is very low and the prognosis is poor, their prenatal diagnosis and obstetric management present a great challenge for the planning of a follow-up and treatment of the disease in accordance with the preferences of the parents.
