Oclusión temporal de arterias ilíacas internas en cesárea-histerectomía por placenta acreta: enfoque multidisciplinario

objective: to report the treatment of a clinical case with central placenta previa accreta. during pregnancy image diagnosis (ultrasound and magnetic resonance imaging) revealed localization and penetration of the placenta into the uterine wall. just before delivery to reduce the bloss loss and avoid maternal hypotension and facilitate surgery, intra arterial balloons were placed on both hypogastric arteries by the radiologist; intravascular monitoring was installed by anesthesist and urologist put in ureteral catheters. the delivery was by cesarean section and followed by histerectomy leaving the placenta in situ. the case correspond to a woman of 32 years old that had 2 previous cesarean section. during this pregnancy bled a few times and was delivered at weeks 36th. during surgery she was stable, requiring one unit of red blood cells and four liters of coloids and crystaloids. post-operative course was with no problems. the pathologist report a placenta percreta with no bladder involvement, agreeing with the vascular lakes image and the cystoscopy. conclusion: this case reveals the benefits of multidisciplinary approach to manage severe complications of pregnancy such as placenta previa and the degree of accretism.