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Ginecología y obstetricia de México

Print version ISSN 0300-9041

Abstract

VILLAGOMEZ-MENDOZA, Edgar Allan; GOMEZ-FERNANDEZ, Alejandra  and  OROZCO-GUTIERREZ, Israel. Uterine rupture and trophoblastic invasion to the bladder. A case report. Ginecol. obstet. Méx. [online]. 2018, vol.86, n.12, pp.841-849.  Epub Sep 30, 2020. ISSN 0300-9041.  https://doi.org/10.24245/gom.v86i12.2309.

BACKGROUND:

The Uterine rupture by placenta percreta is an extremely rare complication between the 0.02-0.08% frequency, the concomitant incidence of placental to bladder invasion occurs in approximately 1 in every 10,000 births, and when this occurs maternal and fetal mortality increases by 9.5% and 24% respectively.

CLINICAL CASE:

A 27 years-old patient, with 26 weeks of gestation (SDG), antecedent of a caesarean, who goes to the emergency department for sudden abdominal pain, compatible with acute abdomen and hemodynamic deterioration, abdominal ultrasound was performed reporting free liquid in cavity, enters the operating room for exploratory laparotomy, finding uterine rupture with presence of trophoblastic invasion to bladder, 2500cc of hemoperitoneum, cesarean section hysterectomy, clamping of uterine arteries via abdominal and ligation of hypogastric arteries, by bladder trophoblastic invasion, during dissection the bladder was injured; a newborn with a weight of 850gr, size 32cm, Ballard 27SDG, APGAR 7/8, total blood loss 3500cc, course 5 days in the Intensive Care Unit (ICU) and 12 days of hospital stay was obtained, the patient progressed favorably , it is graduated with reference to gynecological urology.

CONCLUSIONS:

Knowledge of this type of diagnostic entities is fundamental, given its rarity and transcendence, the intentional search for risk factors, clinical signs such as vaginal bleeding or hematuria, make timely detection the goal to achieve success in the treatment.

Keywords : Acretism; Previous placenta; Placental invasion; Bladder trophoblastic invasion; Uterine rupture.

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