<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0300-9041</journal-id>
<journal-title><![CDATA[Ginecología y obstetricia de México]]></journal-title>
<abbrev-journal-title><![CDATA[Ginecol. obstet. Méx.]]></abbrev-journal-title>
<issn>0300-9041</issn>
<publisher>
<publisher-name><![CDATA[Federación Mexicana de Colegios de Obstetricia y Ginecología A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0300-90412020000800007</article-id>
<article-id pub-id-type="doi">10.24245/gom.v88i8.3619</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Tratamiento con drenaje percutáneo ecoguiado de hematomas vesicouterinos postcesárea complicados. Experiencia en 4 casos]]></article-title>
<article-title xml:lang="en"><![CDATA[Treatment with ultrasound-guided percutaneous drainage of complicated post-cesarean vesicouterine hematomas. Experience in 4 cases]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Álvarez-Sarrado]]></surname>
<given-names><![CDATA[Leticia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Puente-Luján]]></surname>
<given-names><![CDATA[María Jesús]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[González-Ballano]]></surname>
<given-names><![CDATA[Isabel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martínez-Suñer]]></surname>
<given-names><![CDATA[Silvia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ortega-Marcilla]]></surname>
<given-names><![CDATA[Silvia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rodríguez-Solanilla]]></surname>
<given-names><![CDATA[Belén]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Universitario Materno-Infantil Miguel Servet  ]]></institution>
<addr-line><![CDATA[Zaragoza ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Universitario Materno-Infantil Miguel Servet  ]]></institution>
<addr-line><![CDATA[Zaragoza ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital Universitario Materno-Infantil Miguel Servet servicio de Obstetricia y Ginecología ]]></institution>
<addr-line><![CDATA[Zaragoza ]]></addr-line>
<country>España</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2020</year>
</pub-date>
<volume>88</volume>
<numero>8</numero>
<fpage>542</fpage>
<lpage>548</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0300-90412020000800007&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0300-90412020000800007&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0300-90412020000800007&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  ANTECEDENTES:  Los hematomas vesicouterinos sobreinfectados son una rara complicación de la histerotomía segmentaria transversa. La acumulación de sangre entre la pared posterior de la vejiga y el segmento uterino facilita la proliferación de microorganismos patógenos. Cuando el tratamiento antibiótico falla deben plantearse técnicas invasivas para su resolución, entre las que destaca el drenaje percutáneo ecoguiado.  CASOS CLÍNICOS:  Se exponen 4 casos de mujeres que, después de la cesárea, iniciaron con descenso del hematocrito, fiebre (3 casos) y cuadro pseudooclusivo (1 caso). Con base en la ecografía se estableció el diagnóstico de hematoma vesicouterino sobreinfectado. Después de la falla del tratamiento con antibióticos se propuso el drenaje percutáneo ecoguiado. Se observó mejoría clínica en todos los casos de forma significativa. El cultivo del material drenado orientó al tratamiento antibiótico específico. La evolución de las pacientes fue satisfactoria.  CONCLUSIONES:  El drenaje percutáneo ecoguiado permite evacuar el contenido hemático, obtener suficiente muestra para el cultivo y aportar información del microorganismo patógeno concreto. Además, es una técnica efectiva, menos invasiva que la cirugía y se asocia con escasas complicaciones.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  BACKGROUND:  Infected bladder-flap hematomas are a rare complication after a lower uterine segment caesarean section. This blood collection located in the space between the posterior bladder wall and the lower uterine segment allows microorganism proliferation. When the treatment with antibiotics fails, invasive techniques are considered, such as ultrasound percutaneous drainage.  CLINICAL CASE:  We present 4 cases of women whom, after the performance of a cesarean section, began with a decrease in hemoglobin levels, spiking fevers in 3 cases and pseudo-occlusive symptoms in the other one. With an ultrasound examination, the diagnosis of infected bladder-flap hematomas were achieved. After the failure of the antibiotics treatment, an ultrasound percutaneous drainage was performed. As a result of the evacuation of the collection, the clinical situation improved significantly. Culture of the sample obtained permitted to establish a more effective antibiotic treatment.  CONCLUSIONS:  Ultrasound percutaneous drainage allows not only the evacuation of the blood collection to obtain a sample for culture, but also provides information about the presence of a specific microorganism. Moreover, it is a highly efficient technique, less invasive than surgery which presents few complications.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Hematoma vesicouterino]]></kwd>
<kwd lng="es"><![CDATA[fiebre]]></kwd>
<kwd lng="es"><![CDATA[cesárea]]></kwd>
<kwd lng="es"><![CDATA[drenaje percutáneo ecoguiado]]></kwd>
<kwd lng="es"><![CDATA[antibióticos]]></kwd>
<kwd lng="en"><![CDATA[Bladder-flap Hematoma]]></kwd>
<kwd lng="en"><![CDATA[Fever]]></kwd>
<kwd lng="en"><![CDATA[Cesarean Section]]></kwd>
<kwd lng="en"><![CDATA[Ultrasound Percutaneous Drainage]]></kwd>
<kwd lng="en"><![CDATA[Antibiotics]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gemer]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Sonographically diagnosed pelvic hematomas and postcesarean febrile morbidity]]></article-title>
<source><![CDATA[Int J Gynaecol Obstet]]></source>
<year>1999</year>
<volume>65</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>7-9</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Elsersy]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Usefulness of bladder dissection in cesarean section a randomized controlled trial]]></article-title>
<source><![CDATA[Int J Reprod Contracept Obstet Gynecol]]></source>
<year>2016</year>
<volume>5</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>4317-20</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Malvasi]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Should the visceral peritoneum at the bladder flap closed at cesarean sections A post-partum sonographic and clinical assessment]]></article-title>
<source><![CDATA[J Matern Fetal Neonatal Med]]></source>
<year>2010</year>
<volume>23</volume>
<numero>7</numero>
<issue>7</issue>
<page-range>662-9</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ilhan]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Risk factors of wound infections following cesarean delivery experience of a single institution]]></article-title>
<source><![CDATA[J Infect Chemother]]></source>
<year>2016</year>
<volume>22</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>667-70</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Winsett]]></surname>
<given-names><![CDATA[MZ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Sonographic demonstration of bladder-flap hematoma]]></article-title>
<source><![CDATA[J Ultrasound Med]]></source>
<year>1986</year>
<volume>5</volume>
<numero>9</numero>
<issue>9</issue>
<page-range>483-7</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tinelli]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Laparoscopic treatment of post-cesarean section bladder flap hematoma: A feasible and safe approach]]></article-title>
<source><![CDATA[Minim Invasive There Allied Technol]]></source>
<year>2009</year>
<volume>18</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>356-60</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="">
<collab>Sociedad Española de Radiología Médica</collab>
<source><![CDATA[Drenaje percutáneo de abscesos y colecciones líquidas. Estándar del procedimiento]]></source>
<year></year>
<publisher-loc><![CDATA[Madrid ]]></publisher-loc>
</nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Baker]]></surname>
<given-names><![CDATA[ME]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Sonography of post-cesarean-section bladder-flap hematoma]]></article-title>
<source><![CDATA[AJR Am J Roentgenol]]></source>
<year>1985</year>
<volume>144</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>757-9</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Faustin]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Relationship of ultrasound findings after cesarean section to operative morbidity]]></article-title>
<source><![CDATA[Obstet Gynecol]]></source>
<year>1985</year>
<volume>66</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>195-8</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ilhan]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A case of bladder flap hematoma presenting with hematuria]]></article-title>
<source><![CDATA[IJWHR]]></source>
<year>2016</year>
<volume>4</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>205-7</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tinelli]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Conservative laparoscopic treatment of post-caesarean section bladder flap haematoma two case reports]]></article-title>
<source><![CDATA[Gynecol Surg]]></source>
<year>2007</year>
<volume>4</volume>
<page-range>53-6</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Malvasi]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The post-cesarean section symptomatic bladder flap hematoma a modern reappraisal]]></article-title>
<source><![CDATA[J Matern Fetal Neonatal Med]]></source>
<year>2007</year>
<volume>20</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>709-14</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Acholonu]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Percutaneous drainage of fluid collections in the bladder flap of febrile post-cesarean-section patients A report of seven cases]]></article-title>
<source><![CDATA[J Reprod Med]]></source>
<year>1987</year>
<volume>32</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>140-3</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ryan]]></surname>
<given-names><![CDATA[KJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Streptococci and Enterococci]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Ryan]]></surname>
<given-names><![CDATA[KJ]]></given-names>
</name>
<name>
<surname><![CDATA[Ray]]></surname>
<given-names><![CDATA[CG]]></given-names>
</name>
</person-group>
<source><![CDATA[Sherris medical microbiology. An introduction to infectious deseases]]></source>
<year>2004</year>
<edition>4</edition>
<publisher-loc><![CDATA[New York ]]></publisher-loc>
<publisher-name><![CDATA[McGraw-Hill]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Roberts]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Maccato]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Faro]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Pinell]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The microbiology of post-cesarean wound morbidity]]></article-title>
<source><![CDATA[Obstet Gynecol]]></source>
<year>1993</year>
<volume>81</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>383-6</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
