Placenta Percreta: Preparing For The Worst To Provide The Best Care
A 40 y.o. G9P4133 female at 33w6d with a history of four Cesarean deliveries (CD) was scheduled for repeat CD. Ultrasonography confirmed placenta previa with no evidence of placenta accreta. Due to the patient's multiple risk factors for morbidly adherent placenta, the anesthesia team prepared for massive hemorrhage. After closure of the hysterotomy, the surgeons did not see any evidence of invasive disease, however, during dissection for the hysterectomy, there was massive blood loss, and the patient required 40 units of blood products. This case will discuss risk factors and pathophysiology of placenta accreta, and intraoperative management of postpartum hemorrhage.
Kraemer J, Toma B, Vahabzadeh C. Placenta percreta: Preparing for the worst to provide the best care. Abstract presented at: Anesthesiology 2019. American Society of Anesthesiology, Orlando, FL; 2019 October 19-23.