Postpartum hemorrhage (PPH) is the most cause of maternal mortality all over the world important. Its prevalence is about 4 cases in 10,000 deliveries. However, the risk of maternal death is nearly 16% of all maternal deaths in developing countries, especially in Africa. It depends on the resources to stop bleeding, medical and surgical. The first ones are uterotonics medication (prostaglandin, methylergonovine and oxytocin), and the latest professional apt to perform surgical procedures, such as B-Lynch surgery and the peripartum hysterectomy. A woman, 20 years old, GI, P0, A0, with a single pregnancy, 42 weeks of gestational age and 5 prenatal bookings was attended at the emergency on April 12 th 2015. The next day the patient delivered a male baby. The uterus was soft and at the examination she expelled a great amount of clots. She was prescribed Ringer lactate 500 ml + oxytocin 15 IU + methylergonovine 0.2 mg IM + misoprostol 800 µg per rectum. She continued bleeding and a hysterectomy was performed. The patient was discharge in good condition. The pathology revealed myometrium permeated by trophoblasts (placenta accreta).
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