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Retrospective evaluation of anesthetic management in cesarean sections of pregnant women with placental anomaly

Anesthesiology Research and Practice May 05, 2020

Urfalıoglu A, Öksüz G, Bilal, et al. - Researchers undertook this retrospective analysis in a university hospital in Kahramanmaras, Turkey, to examine 95 patients who had cesarean section and had placenta previa and placenta accreta as well as to compare these patients in terms of haemorrhagic indicators and perioperative anesthetic management. Two groups of pregnant women were defined: Group P (previa) (n = 67) and Group A (accreta) (n = 28). General anesthesia (GA) was received by 50 patients (74.6%) in Group P and 27 patients (96.4%) in Group A; in these respective groups, spinal anesthesia (SA) was received by 17 patients (25.4%) and one patient (3.6%). In Group P and in Group A, the estimated mean blood loss was 685.82 ± 262.82 and 1582.14 ± 790.71, respectively. Higher amount of crystalloid was administered in Group A with an average of 1628.57 ± 728.19 ml. In Group A vs Group P, higher use of erythrocyte and fresh frozen plasma solution was also reported. A significantly higher postoperative mechanical ventilation duration was observed in Group A, along with a longer ICU stay of 2.80 ± 1.13 days. Overall, in placental anomalies cases, intraoperative management and the availability of postoperative ICU conditions were concluded to be crucial. To ensure a reduction in morbidity and mortality, a great benefit can be derived through the communication between operation team about the development of a standard protocol for these cases.

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