[Modified cesarean-hysterectomy technique for management of placenta accreta].
BAKGROUND: Obstetric hemorrhage is a major cause of maternal morbidity. The increasing number of births via cesarean has increased the incidence of placenta accreta worldwide. As new techniques aimed at reducing maternal mortality and morbidity have emerged with varying results.


OBJECTIVE
To describe the surgical technique used in our hospital for management of placenta accreta. Report outcomes and maternal complications.


METHODS
Descriptive study, data were obtained from clinical records of patients diagnosed with placenta accreta and whose management was by our modified technique cesarean-hysterectomy by a multidisciplinary team. We included patients who were treated at the Hospital Civil de Guadalajara Dr. Juan I. Menchaca in the period from April 1, 2008 to November 1, 2012.


RESULTS
23 patients were included. The mean gestational age at Doppler ultrasound diagnosis was 31 +/- 3 weeks and for termination of pregnancy was 34 +/- 1 weeks of gestation. Only 5 patients were admitted to intensive care, one patient suffer bladder injury noticed and repaired.


CONCLUSIONS
Our modified technique cesarean-hysterectomy for management of placenta accreta has reduced mortality and morbidity in our hospital as well as injuries to nearby organs and hospital stay.
Rafael
R
Sánchez-Peña
Fabiola Elizabeth
FE
García-Padilla
América Aimé
AA
Corona-Gutiérrez
Bertha Fabiola
BF
Sánchez-García
D000328:Adult; D002585:Cesarean Section / Q000379:methods*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D007902:Length of Stay; D008428:Maternal Mortality; D008800:Mexico; D010348:Patient Care Team; D010921:Placenta Accreta / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006473:Postpartum Hemorrhage / Q000209:etiology / Q000601:surgery*; D011247:Pregnancy; D012189:Retrospective Studies; D018608:Ultrasonography, Doppler / Q000379:methods