[Anesthetic management of patients with placenta previa accreta for cesarean section: a 7-year single-center experience].

BACKGROUND

Anesthetic management for cesarean section of patients with placenta previa accreta is challenging. The aim of this retrospective study was to review past placenta previa accreta cases in our hospital to propose a better strategy for anesthetic management for this difficult condition.

METHODS

Cases of placenta previa accreta were identified in our anesthesia database. The diagnosis, surgical procedure, amount of blood loss and anesthetic management were reviewed.

RESULTS

Eight cases of placenta previa accreta were identified. Four of the eight cases underwent stepwise treatment, and in one of the four cases, intra-aortic balloon occlusion (IABO) was performed. The amount of blood loss in the four cases ranged from 840 to 1,150 ml. The remaining four cases underwent cesarean hysterectomy. The amount of blood loss in the four cases ranged from 2,400 to 5,200 ml. Neuraxial anesthesia alone was planned in four cases, but in two of which anesthesia was converted to general anesthesia due to massive bleeding.

CONCLUSIONS

The present retrospective study showed that stepwise treatment and using IABO could be an effective aid for management of plasenta previa accreta. It is necessary to compare the effectiveness of IABO with that of common iliac artery occlusion in reducing the amount of blood loss.