title: [Scheduled hysterectomy vs. urgent hysterectomy in patients with placenta accreta in a high specialty medical unit].
abstract: BACKGROUND
  Patients with placenta accreta have a high frequency of complications and death risk.
  
  
  OBJECTIVE
  The aim of this study was to compare the results of scheduled hysterectomy vs. urgent hysterectomy in patients with placenta accreta in a high specialty medical unit.
  
  
  METHODS
  An observational, comparative, cross-sectional study was conducted by reviewing patient records with confirmed diagnostic of placenta accreta, who attended in a one year period. They were divided into 2 groups based on the type of surgery, scheduled or urgent. Descriptive statistics were applied, with comparisons using Student t-test and chi squared tests. A value of P<.05 was considered significant.
  
  
  RESULTS
  There were 4,592 births in the period of study, and 125 obstetric hysterectomies were performed, with 40 confirmed cases of accreta (8.7 per thousand births) with 20 in scheduled and 20 in urgent surgeries, with the most frequent type being placenta accreta. The mean maternal age was 32 years, with a mean of 5 hours operating time, total bleeding 3135 ml, and 3.5 units of packed cells transfused. There was no statistical difference when comparing these variables with re-interventions, hypovolaemic shock, and intensive care unit admission. Caesarean-hysterectomy with hypogastric artery ligation was the most frequent surgery performed.
  
  
  CONCLUSIONS
  In this hospital, scheduled and urgent surgical treatment of patients with placenta accreta show similar results, probably because the constant availability of resources and the experience obtained by the multidisciplinary team in all shifts. Nevertheless, make absolutely sure to perform elective surgery while having all the necessary resources.
authors.affiliation: Unidad Médica de Alta Especialidad (UMAE), Hospital de Ginecología y Obstetricia No. 3 (HGO3), Centro Médico Nacional (CNM) La Raza, Instituto Mexicano del Seguro Social (IMSS), México, D. F., México.
authors.forename: Erika
authors.initials: E
authors.lastname: Sumano-Ziga
authors.affiliation: Unidad Médica de Alta Especialidad (UMAE), Hospital de Ginecología y Obstetricia No. 3 (HGO3), Centro Médico Nacional (CNM) La Raza, Instituto Mexicano del Seguro Social (IMSS), México, D. F., México. Electronic address: maria.veloz@imss.gob.mx.
authors.forename: María Guadalupe
authors.initials: MG
authors.lastname: Veloz-Martínez
authors.affiliation: Unidad Médica de Alta Especialidad (UMAE), Hospital de Ginecología y Obstetricia No. 3 (HGO3), Centro Médico Nacional (CNM) La Raza, Instituto Mexicano del Seguro Social (IMSS), México, D. F., México.
authors.forename: Juan Gustavo
authors.initials: JG
authors.lastname: Vázquez-Rodríguez
authors.affiliation: Unidad Médica de Alta Especialidad (UMAE), Hospital de Ginecología y Obstetricia No. 3 (HGO3), Centro Médico Nacional (CNM) La Raza, Instituto Mexicano del Seguro Social (IMSS), México, D. F., México.
authors.forename: Geomar
authors.initials: G
authors.lastname: Becerra-Alcántara
authors.affiliation: Unidad Médica de Alta Especialidad (UMAE), Hospital de Ginecología y Obstetricia No. 3 (HGO3), Centro Médico Nacional (CNM) La Raza, Instituto Mexicano del Seguro Social (IMSS), México, D. F., México.
authors.forename: Carlos Ramón
authors.initials: CR
authors.lastname: Jimenez Vieyra
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004638:Emergency Treatment; D005260:Female; D006757:Hospital Units; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D008875:Middle Aged; D010921:Placenta Accreta / Q000601:surgery*; D011247:Pregnancy; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Placenta accreta; hemorragia obstétrica; histerectomía obstétrica; obstetric haemorrhage; obstetric hysterectomy; placenta acreta