Vol 83, No 2 (2012)
ARTICLES
Management of anesthesia for cesarean section in parturients with placenta previa with/without placenta accreta: A retrospective study
Nazan Kocaoglu, Ilkben Gunusen, Semra Karaman, Ahmet Mete Ergenoglu, Vicdan Firat
Vol 83, No 2 (2012)
ARTICLES
Abstract
Objectives: The aim of this retrospective study was to review placenta previa cases and determine the prognostic factors effective on morbidity and mortality and to evaluate the strategy of anesthetic management. Material and methods: 65 women with placenta previa scheduled for elective or emergency cesarean sections from 2004 to 2009 were examined. Patient demographic data, surgery and obstetric characteristics, anesthetic techniques, blood transfusions, the values of hemoglobin and complications were recorded. Results: Mostly, general anesthesia was preferred in the parturients with placenta previa (86.2%, 56/65). 9 patients (13.8%), 2 of whom were converted to general anesthesia due to bleeding and prolonged surgery, received regional anesthesia. 37 of 65 women (56.9%) with placenta previa had had cesarean sections previously. More than half of these patients (21/37, 56.7%) had abnormally invasive placentation and 16 of 21 cases underwent cesarean hysterectomy. The incidence of complications in women with previous cesarean section with abnormally invasive placentation was higher than in the other women (p<0.0001). Three patients were transferred to the intensive care unit; 2 were intubated and mechanical ventilation was applied, and 1 died of hemorrhage. Conclusions: Anesthetic management is important for parturients with placenta previa who had previous cesarean section or abnormally invasive placentation. We found that general anesthesia was our method of preference for placenta previa as we wished to avoid the risk of bleeding. However, regional anesthesia can be safe in patients lacking any abnormally invasive placentation.
Abstract
Objectives: The aim of this retrospective study was to review placenta previa cases and determine the prognostic factors effective on morbidity and mortality and to evaluate the strategy of anesthetic management. Material and methods: 65 women with placenta previa scheduled for elective or emergency cesarean sections from 2004 to 2009 were examined. Patient demographic data, surgery and obstetric characteristics, anesthetic techniques, blood transfusions, the values of hemoglobin and complications were recorded. Results: Mostly, general anesthesia was preferred in the parturients with placenta previa (86.2%, 56/65). 9 patients (13.8%), 2 of whom were converted to general anesthesia due to bleeding and prolonged surgery, received regional anesthesia. 37 of 65 women (56.9%) with placenta previa had had cesarean sections previously. More than half of these patients (21/37, 56.7%) had abnormally invasive placentation and 16 of 21 cases underwent cesarean hysterectomy. The incidence of complications in women with previous cesarean section with abnormally invasive placentation was higher than in the other women (p<0.0001). Three patients were transferred to the intensive care unit; 2 were intubated and mechanical ventilation was applied, and 1 died of hemorrhage. Conclusions: Anesthetic management is important for parturients with placenta previa who had previous cesarean section or abnormally invasive placentation. We found that general anesthesia was our method of preference for placenta previa as we wished to avoid the risk of bleeding. However, regional anesthesia can be safe in patients lacking any abnormally invasive placentation.
Keywords
Placenta Previa, Placenta Accreta, cesarean section, anesthesia
Title
Management of anesthesia for cesarean section in parturients with placenta previa with/without placenta accreta: A retrospective study
Journal
Ginekologia Polska
Issue
Vol 83, No 2 (2012)
Page views
872
Article views/downloads
1436
Bibliographic record
Ginekol Pol 2012;83(2).
Keywords
Placenta Previa
Placenta Accreta
cesarean section
anesthesia
Authors
Nazan Kocaoglu
Ilkben Gunusen
Semra Karaman
Ahmet Mete Ergenoglu
Vicdan Firat