OBJECTIVE:

Describe step by step, the surgical approach of obstetric hysterectomy that we are doing in our center for the treatment of patients with placental acretism.

MATERIALS AND METHODS:

Retrospective study of the file review of 4 cases of pregnant patients with placental accreta, performed at the San José de Monterrey Hospital, by the ISSSTELEON obstetrics service, conducted between July 2017 to May 2018. They were analyzed using descriptive statistics surgical time, trans operative bleeding, pre and post operative hemoglobin, days of hospitalization, transition to therapy, trans surgical complications. A description was also made of the steps taken by the obstetrics team and the multidisciplinary support team.

RESULTS:

4 hysterectomies were performed, obtaining decrease in trans operative bleeding, no globular packages were used; discharge from the 3rd to 6th day post surgery. There were no re-hospitalizations or re-interventions in the puerperal period; three of the 4 patients went to intermediate care for the first 24 hours for observation. Patients were not transferred to intensive care. During the procedures the newborns went to neonatal care without complications.

CONCLUSIONS:

The approach of these patients has always represented a great challenge, due to their high morbidity and surgical morbidity. In this work we show an innovation in the approach of these patients, which has its cornerstone in pre-operative planning and multidisciplinary work of different specialties, with favorable results in the management and prognosis of these patients.

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