Placenta percreta con invasión a vejiga; reporte de un caso y descripción de la técnica quirúrgica / Placenta percreta with invasion of the bladder: case report and description of surgical technique

RESUMEN

La placenta percreta es una de las variedades de acretismo placentario más graves, con consecuencias catas-tróficas, entidad rara con alta morbimortalidad materno-fetal. Se reporta un caso de una paciente de 18 años con antecedente de una cesárea, que cursó con embarazo de 36 semanas de gestación y acude por sangrado transvaginal. Durante su estancia se corrobora diagnóstico de placenta previa parcial y acretismo placentario. Durante la laparotomía se observa placenta percreta con invasión a vejiga. Actualmente hay diversos abordajes quirúrgicos, todos encaminados a disminuir complicaciones asociadas; en este caso se realizó cesárea-histerectomía modificada como una alternativa terapéutica a considerar

ABSTRACT

Placenta percreta is one of the most serious varieties of placental accreta, with catastrophic consequences, a rare entity with high maternal-fetal morbidity and mortality. We report a case of an 18-year-old woman with a history of a cesarean section, who was pregnant at 36 weeks of gestation and went for transvaginal bleeding. During her stay, diagnosis of partial placenta previa and placental accreta was corroborated. During the laparotomy she was observed placenta percreta with bladder invasion. There are currently several surgical approaches, all aimed at reducing associated complications; in this case modified cesarean-hysterectomy was performed as a therapeutic alternative to be considered