open access

Vol 83, No 2 (2012)
ARTICLES
Get Citation

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
Ginekol Pol 2012;83(2).

open access

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.
Get Citation

Keywords

Placenta Previa, Placenta Accreta, cesarean section, anesthesia

About this article
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

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., ul. Świętokrzyska 73, 80–180 Gdańsk
tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl