Neuraxial Anesthesia During Cesarean Delivery for Placenta Previa With Suspected Morbidly Adherent Placenta: A Retrospective Analysis

Anesthesia and Analgesia
John C MarkleyDaniela Carusi

Abstract

General anesthesia (GA) is often selected for cesarean deliveries (CD) with placenta previa and suspected morbidly adherent placenta (MAP) due to increased risk of hemorrhage and hysterectomy. We reviewed maternal outcomes and risk factors for conversion to GA in a cohort of patients undergoing CD and hysterectomy under neuraxial anesthesia (NA). We performed a single-center, retrospective cohort study of parturients undergoing nonemergent CD for placenta previa with suspected MAP from 1997 to 2015. Patients were classified according to whether they received GA, NA, or intraoperative conversion from NA to GA. The primary outcome measure was postoperative acuity, defined as the need for intensive care unit admission, arterial embolization, reoperation, or ongoing transfusion with ≥3 units packed red blood cells. We additionally identified variables positively associated with intraoperative conversion from NA to GA during hysterectomy. Confounding was controlled with logistic regression models. Of 129 patients undergoing nonemergent CD for placenta previa with suspected MAP, 122 (95%) received NA as the primary anesthetic. NA was selected in the majority of patients with a body mass index ≥40 kg/m (9 of 10, 90%), a history of ≥3 ...Continue Reading

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Citations

May 22, 2018·Anesthesia and Analgesia·John C MarkleyDaniela A Carusi
May 22, 2018·Anesthesia and Analgesia·Mohamed Mohamed TawfikMohamed Elsayed Taman
Mar 19, 2019·Anesthesia and Analgesia·John C MarkleyDaniela A Carusi
Sep 15, 2018·Anesthesia and Analgesia·Yaakov Beilin
Apr 24, 2020·Current Opinion in Anaesthesiology·Alexander IoscovichDaniel Shatalin
Mar 31, 2021·International Journal of Obstetric Anesthesia·B D Einerson, C F Weiniger
Mar 30, 2021·Indian Journal of Anaesthesia·Leidy Johanna Lopez-ErazoAlbaro Jose Nieto-Calvache
Sep 6, 2020·Best Practice & Research. Clinical Obstetrics & Gynaecology·Richard HawkinsEmma Evans
Apr 22, 2021·Curēus·Islam Mohammad ShehataOmar Viswanath
May 4, 2021·Current Opinion in Anaesthesiology·Jessica MerrillNadir Sharawi
Jan 19, 2021·BJA Education·C DelgadoM C Mushambi

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