open access

Vol 91, No 2 (2020)
Research paper
Published online: 2020-02-28
Get Citation

Mode of anesthesia for cesarean delivery with pernicious placenta previa — a retrospective study

Xingxing Liu12, Yuhang Zhu2, Di Ke3, Dexing Liu2, Zhaoqiong Zhu12
·
Pubmed: 32141055
·
Ginekol Pol 2020;91(2):91-94.
Affiliations
  1. Soochow University, Suzhou, China
  2. Department of Anesthesiology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
  3. Department of Emergency, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China

open access

Vol 91, No 2 (2020)
ORIGINAL PAPERS Obstetrics
Published online: 2020-02-28

Abstract

Objectives: Anesthesia for cesarean delivery in parturients diagnosed with pernicious placenta previa remains controversial. This study aimed to review pernicious placenta previa cases to evaluate anesthetic management strategies. Material and methods: This retrospective analysis included patients who underwent cesarean delivery (CD) for pernicious placenta previa at the Affiliated Hospital of Zunyi Medical University between December 1, 2012 and November 31, 2017. Patient demographic data, obstetric characteristics, anesthetic management, and maternal outcomes were extracted from the hospital’s computerized database. Results: In all, 61 consecutive cases of pernicious placenta previa were identified among 9512 cesarean deliveries. General anesthesia was performed on 27 of the 61 patients (44.3%). Among GA group, 16 (59.3%) had placenta accreta, 8 of whom required cesarean hysterectomy. Also, 13 of the 27 (48.1%) GA patients required transfer to the intensive care unit. The other 34 patients (55.7%) were given regional anesthesia, 9 of whom were converted to general anesthesia due to excessive bleeding and prolonged operation times. Statistical results indicated that regional anesthesia was associated with a significantly shorter operation time, less perioperative blood loss, fewer intraoperative red blood cell transfusions, and a lower incidence of complications. Conclusions: Anesthetic management is important for parturients with pernicious placenta previa. Although regional anesthesia was our preferred method for these patients, general anesthesia is safe for patients with pernicious placenta previa who experience massive blood loss and prolonged operation times.

Abstract

Objectives: Anesthesia for cesarean delivery in parturients diagnosed with pernicious placenta previa remains controversial. This study aimed to review pernicious placenta previa cases to evaluate anesthetic management strategies. Material and methods: This retrospective analysis included patients who underwent cesarean delivery (CD) for pernicious placenta previa at the Affiliated Hospital of Zunyi Medical University between December 1, 2012 and November 31, 2017. Patient demographic data, obstetric characteristics, anesthetic management, and maternal outcomes were extracted from the hospital’s computerized database. Results: In all, 61 consecutive cases of pernicious placenta previa were identified among 9512 cesarean deliveries. General anesthesia was performed on 27 of the 61 patients (44.3%). Among GA group, 16 (59.3%) had placenta accreta, 8 of whom required cesarean hysterectomy. Also, 13 of the 27 (48.1%) GA patients required transfer to the intensive care unit. The other 34 patients (55.7%) were given regional anesthesia, 9 of whom were converted to general anesthesia due to excessive bleeding and prolonged operation times. Statistical results indicated that regional anesthesia was associated with a significantly shorter operation time, less perioperative blood loss, fewer intraoperative red blood cell transfusions, and a lower incidence of complications. Conclusions: Anesthetic management is important for parturients with pernicious placenta previa. Although regional anesthesia was our preferred method for these patients, general anesthesia is safe for patients with pernicious placenta previa who experience massive blood loss and prolonged operation times.

Get Citation

Keywords

anesthesia; anesthetic techniques; obstetric; pernicious placenta previa; regional/general anesthesia

About this article
Title

Mode of anesthesia for cesarean delivery with pernicious placenta previa — a retrospective study

Journal

Ginekologia Polska

Issue

Vol 91, No 2 (2020)

Article type

Research paper

Pages

91-94

Published online

2020-02-28

Page views

2767

Article views/downloads

1350

DOI

10.5603/GP.2020.0023

Pubmed

32141055

Bibliographic record

Ginekol Pol 2020;91(2):91-94.

Keywords

anesthesia
anesthetic techniques
obstetric
pernicious placenta previa
regional/general anesthesia

Authors

Xingxing Liu
Yuhang Zhu
Di Ke
Dexing Liu
Zhaoqiong Zhu

References (20)
  1. Zhu B, Yang K, Cai L. Discussion on the Timing of Balloon Occlusion of the Abdominal Aorta during a Caesarean Section in Patients with Pernicious Placenta Previa Complicated with Placenta Accreta. Biomed Res Int. 2017; 2017: 8604849.
  2. Huang S, Xia A, Jamail G, et al. Efficacy of temporary ligation of infrarenal abdominal aorta during cesarean section in pernicious placenta previa. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2017; 42(3): 313–319.
  3. Chattopadhyay SK, Kharif H, Sherbeeni MM. Placenta praevia and accreta after previous caesarean section. Eur J Obstet Gynecol Reprod Biol. 1993; 52(3): 151–156.
  4. Obstetrics and Gynecology. 8th ed. Peoples Medical Publishing House, Beijing 2013: 126–127.
  5. Chen Z, Li Ju, Shen J, et al. Direct puncture embolization of the internal iliac artery during cesarean delivery for pernicious placenta previa coexisting with placenta accreta. Int J Gynaecol Obstet. 2016; 135(3): 264–267.
  6. Angstmann T, Gard G, Harrington T, et al. Surgical management of placenta accreta: a cohort series and suggested approach. Am J Obstet Gynecol. 2010; 202(1): 38.e1–38.e9.
  7. Hull AD, Moore TR. Multiple repeat cesareans and the threat of placenta accreta: incidence, diagnosis, management. Clin Perinatol. 2011; 38(2): 285–296.
  8. Kocaoglu N, Gunusen I, Karaman S, et al. Management of anesthesia for cesarean section in parturients with placenta previa with/without placenta accreta: a retrospective study. Ginekol Pol. 2012; 83(2): 99–103.
  9. Imarengiaye CO, Osaigbovo EP, Tudjegbe SO. Anesthesia for cesarean section in pregnancies complicated by placenta previa. Saudi Med J. 2008; 29(5): 688–691.
  10. Parekh N, Husaini SW, Russell IF. Caesarean section for placenta praevia: a retrospective study of anaesthetic management. Br J Anaesth. 2000; 84(6): 725–730.
  11. Clark SL, Koonings PP, Phelan JP. Placenta previa/accreta and prior cesarean section. Obstet Gynecol. 1985; 66(1): 89–92.
  12. Ayaz A, Farooq MU. Risk of adverse maternal and peri-natal outcome in subjects with placenta previa with previous cesarean section. Kurume Med J. 2012; 59(1-2): 1–4.
  13. Zaki ZM, Bahar AM, Ali ME, et al. Risk factors and morbidity in patients with placenta previa accreta compared to placenta previa non-accreta. Acta Obstet Gynecol Scand. 1998; 77(4): 391–394.
  14. To WW, Leung WC. Placenta previa and previous cesarean section. Int J Gynaecol Obstet. 1995; 51(1): 25–31.
  15. Hong JY, Jee YS, Yoon HJ, et al. Comparison of general and epidural anesthesia in elective cesarean section for placenta previa totalis: maternal hemodynamics, blood loss and neonatal outcome. Int J Obstet Anesth. 2003; 12(1): 12–16.
  16. Chestnut DH, Dewan DM, Redick LF, et al. Anesthetic management for obstetric hysterectomy: a multi-institutional study. Anesthesiology. 1989; 70(4): 607–610.
  17. Imarengiaye CO, Osaigbovo EP, Tudjegbe SO. Anesthesia for cesarean section in pregnancies complicated by placenta previa. Saudi Med J. 2008; 29(5): 688–691.
  18. Angileri SA, Mailli L, Raspanti C, et al. Prophylactic occlusion balloon placement in internal iliac arteries for the prevention of postpartum haemorrhage due to morbidly adherent placenta: short term outcomes. Radiol Med. 2017; 122(10): 798–806.
  19. Allam J, Cox M, Yentis SM. Cell salvage in obstetrics. Int J Obstet Anesth. 2008; 17(1): 37–45.
  20. Goucher H, Wong CA, Patel SK, et al. Cell Salvage in Obstetrics. Anesth Analg. 2015; 121(2): 465–468.

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