Anesthesia for the repeat cesarean section in the parturient with abnormal placentation: What does an obstetrician need to know?
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Placenta accreta is an abnormal adherence of the placenta to the uterine wall owing to an absent or faulty decidua basalis. The incidence of this devastating problem is increasing secondary to the increased incidence of Cesarean section. Although rare, the diagnosis of placenta accreta may lead to life-threatening complications (e.g., fatal hemorrhage) and significantly impact the obstetric and anesthetic management of these parturients. I herein present the case of a pregnant patient with abnormal placentation and review the current state-of-the-art obstetric and anesthetic management of this complication.
KeywordsPregnancy Complications Abnormal placentation Placenta acreta Increta Percreta Previa Bleeding Cesarean section Hysterectomy Obstetric anesthesia Complications
To the loving memory of my mother Mieczyslawa Barbara Kuczowska who lost a battle with cancer on June 29, 2005 in San Diego, California. Everything I have accomplished in life I owe to her, her wisdom, guidance, inspiration and love. Krzysztof M. Kuczkowski, M.D. San Diego, California, USA, October 25, 2005
- 1.Mayer DC, Spielman FJ, Bell EA (2004) Antepartum and postpartum hemorrhage. In: Chestnut DH (ed) Obstetric Anesthesia: principles and practice, 3rd edn. Elsevier, Amsterdam, pp 662–682Google Scholar
- 4.Takai N, Eto M, Sato F, Mimata H, Miyakawa I (2004) Placenta percreta invading the urinary bladder. Arch Gynecol Obstet 27 July 2004 [Epub ahead of print]Google Scholar
- 7.Kuczkowski KM, Eisenmann UB (2005) Nitrous oxide as a cause of internal iliac artery occlusion balloon rupture. Ann Fran Anesth Reanim 24:564Google Scholar
- 10.Zelop CM, Harlow BL, Frigoletto FD et al (1993) Emergency peripartum hysterectomy. Obstet Genecol 168:1443–1448Google Scholar
- 11.Kuczkowski KM (2005) Anesthesia for the repeat Cesarean section in the parturient with abnormal placentation: is there cause for concern? Presented at the annual meeting of the American Society of Anesthesiologists in Atlanta, GA, USA, 25 October 2005, Published in problem-based learning discussions, 2005 CD-ROM, American Society of Anesthesiologists Publication Department, 2005Google Scholar