title: Sclerotherapy with 6% polidocanol solution in patients with placenta accreta.
abstract: OBJECTIVE
  Placenta accreta is one of the main obstetrical complications worldwide. The aim of this study was to report the experience of managing placenta accreta with a 6% polidocanol solution sclerotherapy.
  
  
  METHODS
  We selected patients between 37 weeks of gestation and 38 weeks of gestation, diagnosed with placenta accreta, treated at the Maternal Perinatal Hospital "Monica Pretelini Sáenz", Toluca, Mexico, during the period from November 2013 to August 2014. The surgical technique has two steps: (1) fundic-arciform caesarean section followed by a 6% polidocanol sclerosing solution through a 6Fr neonatal feeding tube upon its reaching the placental bed; (2) total abdominal hysterectomy with internal hypogastric artery ligation.
  
  
  RESULTS
  Data were collected from 11 patients with a mean age of 33.9 years (range, 26-42 years) and 2.8±0.6 days of hospitalization in the obstetrical intensive care unit. The majority of patients were classified as having pregnancies at an advanced age. All women were multigravidas. Bleeding volume exhibited a range between 2.5 L and 3 L without any case of neonatal death but one mother died because of coagulopathy.
  
  
  CONCLUSIONS
  We conclude that the technique that we are reporting is feasible for implementation in obstetric hospitals, with technical and economic feasibility.
authors.affiliation: Hospital Materno Perinatal "Mónica Pretelini Sáenz", Instituto de Salud del Estado de México, Toluca, Estado de México, Mexico.
authors.forename: Ricardo Mauricio
authors.initials: RM
authors.lastname: Malagón Reyes
authors.affiliation: Hospital Materno Perinatal "Mónica Pretelini Sáenz", Instituto de Salud del Estado de México, Toluca, Estado de México, Mexico.
authors.forename: Rubén
authors.initials: R
authors.lastname: Castorena de Ávila
authors.affiliation: Hospital Materno Perinatal "Mónica Pretelini Sáenz", Instituto de Salud del Estado de México, Toluca, Estado de México, Mexico.
authors.forename: María de Jesús
authors.initials: MJ
authors.lastname: Ángeles Vázquez
authors.affiliation: Faculty of Medicine, Autonomous University of the State of Mexico, Toluca, Estado de México, Mexico.
authors.forename: César Augusto
authors.initials: CA
authors.lastname: Núñez Monteagudo
authors.affiliation: Faculty of Medicine, Autonomous University of the State of Mexico, Toluca, Estado de México, Mexico; Asociación Científica Latina Asociación Civil (ASCILA), Toluca, Estado de México, Mexico; Ciprés Grupo Médico, Toluca, Estado de México, Mexico. Electronic address: mezh_74@yahoo.com.
authors.forename: Hugo
authors.initials: H
authors.lastname: Mendieta Zerón
mesh_terms: D000328:Adult; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D010921:Placenta Accreta / Q000628:therapy*; D000077423:Polidocanol; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012597:Sclerosing Solutions / Q000008:administration & dosage; D015911:Sclerotherapy / Q000379:methods*
chemical_list: D012597:Sclerosing Solutions; D000077423:Polidocanol; D011092:Polyethylene Glycols
keywords: hypogastric artery ligation; placenta accreta; polidocanol; sclerotherapy