Placenta previa oclusiva total con signos de acretismo secundaria a cirugía uterina anterior

Abstract

The placenta previa is defined as the total or partial insertion of the placenta in the lower segment of the uterus. It is considered responsible for 20% of bleeding in the 3rd trimester, the 3rd cause of blood transfusion in the last stage of gestation and the 2nd cause of radical hysterectomy. It is more frequently associated with older women, a previous caesarean section, induced or spontaneous abortions. The case of a 43-year-old female patient with a surgical history of a previous caesarean section is described. She is in her third 35.1-week pregnancy due to chronological FUM, diagnosed with total occlusive placenta previa and placental accretion confirmed by MRI and obstetric ultrasound. Prior to admission, she presented with contraction-type abdominal pain that radiated to the lumbar region accompanied by small amount of dark bleeding, which is why admission to the Ambato Provincial Teaching Hospital was assessed and the pregnancy was planned to end at 36 weeks. Cesarean section is scheduled at 36 weeks due to the diagnosis of total occlusive Placenta previa with signs of placental accreta. As a complication of the surgical act, a uterine uterine atony is observed, so a total abdominal hysterectomy