Anesthetic management of placenta accreta in a low-resource setting: a case series

International Journal of Obstetric Anesthesia
L A MuñozJ J Arevalo

Abstract

Current recommendations for the anesthetic management of placenta accreta support a conservative approach with neuraxial anesthesia and uterine artery embolization. These are based on case series from experienced centers in developed countries. The aim of this study was to describe the anesthetic management of placenta accreta in a low-resource setting. A retrospective case note review was performed. From 1 August 2006 to 31 July 2011 placentas from cases of suspected placenta accreta were reassessed histologically to confirm the diagnosis. Patient charts were reviewed and information on anesthetic technique, monitoring, blood transfusion, maternal and fetal outcomes was extracted. Thirty-nine cases were identified. Mean (± SD) maternal age was 33 ± 5.4 years. Hysterectomy was performed at the time of cesarean section in all cases. Thirty-four patients received neuraxial anesthesia, of whom 15 required conversion to general anesthesia. Invasive blood pressure monitoring was used in all patients and a central venous catheter was inserted in 33 cases. Complications associated with monitoring occurred in five patients. Median [IQR] blood loss was 2000 [1100-2700] mL and the median [IQR] number of units of red blood cell transfused...Continue Reading

References

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Sep 23, 2014·Anesthesia and Analgesia·Rachel M KacmarPaloma Toledo

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Citations

Oct 29, 2017·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Efrain Riveros-Perez, Cristina Wood
Feb 7, 2018·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Lisa AllenUNKNOWN FIGO Placenta Accreta Diagnosis and Management Expert Consensus Panel
Mar 30, 2021·Indian Journal of Anaesthesia·Leidy Johanna Lopez-ErazoAlbaro Jose Nieto-Calvache
Sep 10, 2020·Best Practice & Research. Clinical Obstetrics & Gynaecology·M F EscobarK Gunawardana

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