[Anaesthesia and recovery in a case of placenta percreta].
Placenta percreta is a sub-type of placenta accreta in which this organ invades the whole uterine wall and affects the adjacent organs. It is a condition with a high surgical risk which generally requires an obstetric hysterectomy. We present the case of a 36 year-old pregnant woman diagnosed with placenta percreta with bladder and intestinal invasion. She suffered a hypovolaemic shock during surgery which required a massive transfusion of blood products and inotropic support. Three further successive surgeries were required due to the bleeding, with selective embolisation of the hypogastric arteries being performed in one of them. She required 13 days in intensive care. The total volume of blood products transfused was, 43 units of red cells, 28 units of plasma, and 8 platelet pools. The importance of early prenatal diagnosis is emphasised in order to adequately plan the operation, and should include a multidisciplinary team (general surgeons, urologists, vascular surgeons), as well as experienced anaesthesiologists and obstetricians.
Servicio de Anestesiología y Reanimación, Hospital de Cabueñes, Gijón, Asturias, España. Electronic address: mbermej@hotmail.com.
M A
MA
Bermejo Álvarez
D
D
Soto Mesa
R
R
González Castaño
I
I
Blanco Rodríguez
V
V
del Valle Ruiz
D058107:Abdominal Wound Closure Techniques; D000328:Adult; D000768:Anesthesia, General / Q000379:methods*; D001779:Blood Coagulation Factors / Q000627:therapeutic use; D016913:Blood Component Transfusion; D002316:Cardiotonic Agents / Q000627:therapeutic use; D002585:Cesarean Section / Q000379:methods*; D003131:Combined Modality Therapy; D003422:Critical Care / Q000379:methods*; D042241:Early Diagnosis; D004621:Embolization, Therapeutic; D005260:Female; D006465:Hemoperitoneum / Q000209:etiology / Q000601:surgery; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D007231:Infant, Newborn; D007422:Intestines / Q000473:pathology; D007431:Intraoperative Complications / Q000209:etiology / Q000628:therapy; D007813:Laparotomy; D010921:Placenta Accreta / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000601:surgery; D011247:Pregnancy; D011644:Puerperal Disorders / Q000209:etiology / Q000601:surgery; D012769:Shock / Q000209:etiology / Q000628:therapy; D001743:Urinary Bladder / Q000473:pathology
D001779:Blood Coagulation Factors; D002316:Cardiotonic Agents