Császármetszés során felismert placenta percretával szövődött esetünk műtéti megoldása = Surgical treatment of diagnosed placenta percreta during cesarean section

Molnár, András and Jakó, Mária and Surányi, Andrea and Németh, Gábor (2018) Császármetszés során felismert placenta percretával szövődött esetünk műtéti megoldása = Surgical treatment of diagnosed placenta percreta during cesarean section. MAGYAR NŐORVOSOK LAPJA, 81 (2). pp. 280-284. ISSN 0025-021X

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Abstract

Background: To present a case of a 38-year old pregnant woman with an intraoperative diagnosis of placenta percreta complicated by central placenta previa. The ultrasound scan did not show signs of any type of abnormal placental invasion, only central placenta previa was visualized. Material and methods: At 36 weeks of gestation, she underwent an elective cesarean section combined with peripartum hysterectomy with bladder wall resection under general anesthesia because of antenatally undiagnosed placenta percreta. Results: The therapy was provided by a multidisciplinary team. Intraoperative blood loss was 2500 mL. A total of 10 units of red blood cells and 3 units of fresh frozen plasma were used. Anesthesia time was 2 h and 15 min. A live, premature male newborn (2420 g) was delivered 8 min after the beginning of the operation with Apgar scores 8 and 7, 8 at 1st minute and 5st minute and 10st minute. Conclusion: We want to emphasize that, in spite of the lack of typical symptoms and ultrasound signs of placenta percreta, we have to be cautious when the risk factors are present. If we have a suspicion for adherent placenta, a magnetic resonance imaging scan should be performed to start the operation with an accurate diagnosis preparing for possible complications.

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