RESUMO
Conjoined twins are the rare malformations of monozygotic-twins pregnancies associated with bad fetal prognosis. Craniopagus are even more rarely encountered and their management is complex particularly in our low-medical-equipment countries. From an observation of craniopagus twins, we present several difficulties in the management of the case. Diagnosis was late; because of the onset of labour, delivery was not prepared; the conditions of neonatal and social management were not adapted. Surgical treatment was not considered owing to the absence of appropriate technological conditions and means.
Assuntos
Osso Occipital/anormalidades , Crânio/anormalidades , Gêmeos Unidos , Adulto , África , Encéfalo/cirurgia , Cesárea , Países em Desenvolvimento , Evolução Fatal , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Osso Occipital/cirurgia , Gravidez , Terceiro Trimestre da Gravidez , Crânio/cirurgia , Gêmeos , Ultrassonografia Pré-NatalRESUMO
Placenta accreta is an abnormal adherence of placenta to the uterine wall without interposition of decidua basalis. Placenta percreta is the rarest form but may complicate the pregnancy with acute severe hemorrhage. We report a case of placenta percreta with multiple perforations of an unscarred uterus reaveled by hemoperitoneum at 22 weeks in a 33-years-old gravida 2 para 1. Emergency total hysterectomy was performed. Risk factors, clinical approach and therapeutic managements are discussed.