A 21-year-old mother, a native of Chicoral, attended her prenatal check-up in the 34th week of pregnancy, when the doctors found a series of anomalies. After several specialized analyzes, she returned a Spectrum of Placental Accreta as a diagnosis.
This disease occurs when the placenta is abnormally located in a place where there was another surgery, such as cesarean sections, obstetric curettage or myomectomy, as explained by Dr. Andrea Peña, a perinatologist who participated in the surgery. Due to its difficulty, in Colombia there are only two cities that perform this procedure: Bogotá and Cali.
Despite the fact that the Federico Lleras Hospital, where the patient was located, did all the paperwork for her transfer, she was not accepted in either of these two cities. In this way, Federico analyzed and concluded that this woman would be the first patient to receive this surgery in Ibagué, because the necessary indications were available and the process was expedited because the patient had preeclampsia and maternal obesity.
Surgery
For the procedure, those in charge met with the accredited centers and received the necessary guidelines for its development. This is how the process was carried out in a little more than four hours, where a team of 12 people including specialists in urology, obstetrics, perinatology, surgery and anesthesiology participated.
“We bet on preserving the uterus because this organ has more functions other than procreation, it also serves as a support for the pelvic floor to support other organs such as the bladder and avoid prolapse problems later on,” said Dr. Fabián Dorado, a gynecologist. Federico Lleras oncologist.
Thus, in the surgery, a recession of the segment affected by the abnormal infiltration of the placenta was performed and then they made a reconstruction of the uterus, preserving it and preventing it from having other complications due to its absence, such as uterine prolapse. “Normally a hysterectomy is performed, for management we extract the baby through a cesarean section and then we take the patient to a hysterectomy immediately,” said Fabián Dorado
The surgery was a complete success and following a week of recovery, the mother is resting at home with her three children. For its part, the Federico Lleras Hospital seeks to continue improving the treatment of this pathology to join Cali and Bogotá as the only ones that manage it.
The message
Dr. Andrea Peña sent a message to pregnant mothers regarding cesarean sections “Let’s avoid unnecessary cesarean sections without medical indication, since the greatest risk factor in the country is having more than two cesarean sections, this disease can put life at risk of the mother and the baby.
Pregnant patients, with two or more previous caesarean sections, should attend prenatal check-ups and have a placental insertion Doppler performed, which is done by perinatologists, to rule out PAD.