Pinzamiento aórtico como alternativa en el manejo intraoperatorio de hemorragia grave por acretismo placentario: reporte de caso.

Background: Patients with placenta accreta, accreta percreta or are at risk for obstetric hemorrhage critical, appropriate management depends on the ability of a multidisciplinary team and the resources necessary to reduce the risk of critical bleeding and prevent death. Case report: Female 27-year-old epic 2 cesarean 1 with 36.4 weeks gestation and diagnosed with complete placenta previa percretismo and bladder invasion diagnosed by MRI pregnancy. Begins with regulating uterine contractility, so urgent interruption of pregnancy was decided. Obtained female fetus weighing 2,530 grams, Apgar 8/9, Capurro 39.5 weeks, sudden heavy bleeding has thus decided to perform obstetric hysterectomy prior ligation hypogastric arteries unsuccessfully pinched aorta and common iliac arteries proceed , yields bleeding clamping aorta 43 minutes total hysterectomy was finished, vascular control of large vessels is removed, confirming hemostasis. It is terminated proceedings and passed to the intensive care unit, a week after favorable developments the binomial graduates for improvement. Discussion: There is only evidence anecdotally this procedure Palacios-Jaraquemada I use this procedure to perform a conservative surgery anterior placenta to reduce postpartum hemorrhage. A shorter 50-minute aortic clamping is well tolerated and appears to be safe. Conclusions: There is currently no recommendation for use of aortic clamping, however for intraoperative management of severe bleeding appears to be a safe procedure in experienced hands rescue, able to reduce maternal mortality. [ABSTRACT FROM AUTHOR]