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accreta anesthesia

T R Grant, E H Ellinas, A O Kula, M Y Muravyeva
BACKGROUND: Parturients with abnormally adherent placentas present anesthetic challenges that include risk-stratification, management planning and resource utilization. The labor and delivery unit may be remote from the main operating room services. METHODS: Division chiefs of North American obstetric anesthesiology services were surveyed about their practices and management of parturients with an abnormally adherent placenta. RESULTS: Eighty-four of 122 chiefs, representing 103 hospital sites, responded to the survey (response rate 69%)...
May 2018: International Journal of Obstetric Anesthesia
Bharti Sharma, Pooja Sikka, Vanita Jain, Kajal Jain, Rashmi Bagga, Vanita Suri
Background and Aims: Peripartum hysterectomy is associated with significant maternal morbidity and mortality. We reviewed all peripartum hysterectomies at our institute over a 1-year period. The aim of this study was to determine the incidence, surgery and anesthesia-related issues of peripartum hysterectomies and to compare outcomes of emergency and electively planned peripartum hysterectomies. Material and Methods: This was a retrospective analysis of records of women who underwent emergency or elective peripartum hysterectomy in a tertiary care hospital...
July 2017: Journal of Anaesthesiology, Clinical Pharmacology
Efrain Riveros-Perez, Cristina Wood
OBJECTIVE: To assess the management and maternal outcomes of placenta accreta spectrum (PAS) disorders. METHODS: A retrospective chart review was conducted of patients diagnosed with PAS disorders (placenta creta, increta, or percreta) who were treated at a US tertiary care center between February 1, 2011, and January 31, 2016. Obstetric management, anesthetic management, and maternal outcomes were analyzed. RESULTS: A total of 43 cases were identified; placenta previa was diagnosed among 33 (77%)...
March 2018: International Journal of Gynaecology and Obstetrics
Y Wang, H Zeng, X Y Guo, X Y Rong
OBJECTIVE: To investigate the anesthetic choice for patients undergoing cesarean section complicated with placenta implantation. METHODS: A retrospective case review of the patients with placenta implantation between 2008 and 2013 at Peking University Third Hospital was conducted in the International Classification of Diseases (ICD)-9 codes, excluding natural birth and not first diagnosed in our hospital, a total of 96 cases were incorporated into this study. According to the degree of implantation, they were divided into three groups: accreta group, increta group and percreta group...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Karen J Gibbins, Brett D Einerson, Michael W Varner, Robert M Silver
OBJECTIVE: Placenta previa is associated with maternal hemorrhage, but most literature focuses on morbidity in the setting of placenta accreta. We aim to characterize maternal morbidity associated with previa and to define risk factors for hemorrhage. METHODS: This is a secondary cohort analysis of the NICHD Maternal-Fetal Medicine Units Network Cesarean Section Registry. This analysis included all women undergoing primary Cesarean delivery without placenta accreta...
February 2018: Journal of Maternal-fetal & Neonatal Medicine
R S Khokhar, J Baaj, M U Khan, F A Dammas, N Rashid
Placenta accreta (an abnormally adherent placenta) is one of the two leading causes of peripartum hemorrhage and the most common indication for peripartum hysterectomy. Placenta accreta may be associated with significant maternal hemorrhage at delivery owing to the incomplete placental separation. When placenta accreta is diagnosed before delivery, a multidisciplinary approach may improve patient outcome.
July 2016: Saudi Journal of Anaesthesia
A Ioscovich, D Shatalin, A J Butwick, Y Ginosar, S Orbach-Zinger, C F Weiniger
BACKGROUND: Anesthesia practices for placenta previa (PP) and accreta (PA) impact hemorrhage management and other supportive strategies. We conducted a survey to assess reported management of PP and PA in all Israeli labor and delivery units. METHODS: After Institutional Review Board waiver, we surveyed all 26 Israeli hospitals with a labor and delivery unit by directly contacting the representatives of obstetric anesthesiology services in every department (unit director or department chair)...
April 2016: Acta Anaesthesiologica Scandinavica
R Shaylor, Y Ginosar, A Avidan, S Eventov-Friedman, N Amison, C F Weiniger
OBJECTIVE: General anesthesia may be required for placenta accreta cesarean delivery. Intrauterine fetal anesthetic exposure should be minimized to avoid neonatal respiratory depression; opioids are often delayed until post-delivery. METHODS: In this observational study, we compared neonatal outcome using pre-delivery remifentanil versus post-delivery (deferred) opioids for placenta accreta cesarean delivery. Choice of anesthesia was discretionary. The primary outcome was Apgar score at 5 min comparing women who received pre-delivery remifentanil versus deferred opioid administration...
September 2016: Journal of Maternal-fetal & Neonatal Medicine
L A Muñoz, G J Mendoza, M Gomez, L E Reyes, J J Arevalo
BACKGROUND: Current recommendations for the anesthetic management of placenta accreta support a conservative approach with neuraxial anesthesia and uterine artery embolization. These are based on case series from experienced centers in developed countries. The aim of this study was to describe the anesthetic management of placenta accreta in a low-resource setting. METHODS: A retrospective case note review was performed. From 1 August 2006 to 31 July 2011 placentas from cases of suspected placenta accreta were reassessed histologically to confirm the diagnosis...
November 2015: International Journal of Obstetric Anesthesia
S V Nashar, V Dimitrova, V Zlatkov, B Frandeva, A Dimitrov
A case of prolonged retention in the uterus of placenta accreta after vaginal delivery is reported in the paper. The patient was 20 years old G3, P0 with two pregnancy terminations on request. She was admitted to the obstetric department of a regional hospital one day after the EDD with irregular contractions and non reassuring CTG. A few hours later intrauterine fetal demise occurred. Spontaneous labor commenced and a stillborn growth retarded fetus was delivered. Methergin was administered during the third stage of labor, but the placenta was not separated even after repeated Crede maneuvers, the last one under anesthesia...
2015: Akusherstvo i Ginekologii︠a︡
Daniel Frasca
A 41-year-old woman presented to the surgical suite with an undiagnosed placenta percreta invading the bladder. The patient lost 16,000 mL of blood before the hemorrhage was surgically controlled, and a successful cesarean delivery, as well as a total abdominal hysterectomy, were performed. Ultimately, the patient was discharged 1 week later with a healthy baby. Unlike placenta accreta where the placenta strictly adheres to the musculature of the uterus, placenta percreta is a rare condition in which the placenta invades the full thickness of the myometrium and possibly other intra-abdominal organ structures...
October 2012: AANA Journal
Kei Matsuoka, Tetsuya Kawabata, Kouji Yoza
BACKGROUND: Anesthetic management for cesarean section of patients with placenta previa accreta is challenging. The aim of this retrospective study was to review past placenta previa accreta cases in our hospital to propose a better strategy for anesthetic management for this difficult condition. METHODS: Cases of placenta previa accreta were identified in our anesthesia database. The diagnosis, surgical procedure, amount of blood loss and anesthetic management were reviewed...
January 2015: Masui. the Japanese Journal of Anesthesiology
Amanda M Tower, Beth Cronin
BACKGROUND: Postpartum myomectomy is typically discouraged as a result of the risk of hemorrhage and longer operative times. However, myomectomy at the time of cesarean delivery or after a vaginal delivery is feasible and is sometimes necessary. CASE: A 38-year-old multiparous woman with a 9-cm pedunculated submucosal leiomyoma presented in labor and underwent a vacuum-assisted vaginal delivery with manual extraction of the placenta. In the immediate postpartum period she had bleeding and hemodynamic instability requiring blood transfusion...
May 2015: Obstetrics and Gynecology
Guang Tai Li, Xiao Fan Li, Ji Li, Ya Jing Liu, Hong Mei Xu
BACKGROUND/AIMS: Postpartum hemorrhage (PPH) is a life-threatening condition with a worldwide occurrence. The purpose of this study is to evaluate the efficacy and safety of a reflexed compression suture in controlling severe atonic PPH with placenta accreta. METHODS: Eleven women with severe PPH due to uterine inertia or placenta accreta were administered the reflexed compression suture. The procedure was to reflex the fundus onto the anterior wall of the uterus for compressing hemostasis and to form a 'belt-like' binding suture to reinforce the effectiveness of pressing the myometrium...
2015: Gynecologic and Obstetric Investigation
Nobuhiro Noguchi, Shunsuke Izumi, Kota Kamizato, Seiya Nakamura, Manabu Kakinohana, Kazuhiro Sugahara
We studied retrospectively amount of bleeding, clamping time, and the presence or absence of ischemia-reperfusion injury in all seven cases of IABO performed for placenta accreta from 2007 to 2012 at our hospital. We also examined rSO2 change before and after clamping in four cases in which lower-limb rSO2 monitoring was performed with NIRS (near-infrared spectroscopy). There was no case suspected of ischemia-reperfusion injury during and after clamping with the amount of bleeding around 1,580-10,973 ml (mean 4,536 ml) and clamping time of 10-83 min (mean 44 min)...
December 2014: Masui. the Japanese Journal of Anesthesiology
Vineya Rai, Ina I Shariffuddin, Yoo K Chan, Rajesh K Muniandy, Kang K Wong, Sukcharanjit Singh
BACKGROUND: Complete heart block in pregnancy has serious implications particularly during the period of delivery. This is more so if the delivery is an operative one as the presence of heart block may produce haemodynamic instability in the intra operative period. We report a unique case of a pregnant mother with complete heart block undergoing hysterostomy, complicated by placenta accreta and intrauterine death. CASE PRESENTATION: A 37 year old Malaysian Chinese parturient was admitted at 25 weeks gestation following a scan which suggested intrauterine death and placenta accreta...
2014: BMC Anesthesiology
Tania Hall, Joseph R Wax, F Lee Lucas, Angelina Cartin, Michael Jones, Michael G Pinette
PURPOSE: To compare maternal and neonatal outcomes of prenatally diagnosed versus undiagnosed cases of placenta accreta. METHODS: This retrospective study included all pathology-proven placentas accreta/increta/percreta from a single tertiary center from January 1, 2005 to December 31, 2012. Outcomes were compared between prenatally diagnosed and undiagnosed cases. RESULTS: Thirty-six cases of abnormal implantations were identified, of which 19 (53%) were prenatally diagnosed by ultrasound...
October 2014: Journal of Clinical Ultrasound: JCU
Katsuyoshi Kume, Yasuo M Tsutsumi, Tomohiro Soga, Yoko Sakai, Noriko Kambe, Ryosuke Kawanishi, Eisuke Hamaguchi, Tomiya Kawahara, Asuka Kasai, Yoshimi Nakaji, Yousuke T Horikawa, Souichiro Nakayama, Takashi Kaji, Minoru Irahara, Katsuya Tanaka
We describe a case of a 39-year-old woman diagnosed with placenta percreta complicated by massive hemorrhage during a cesarean section. At 27 weeks of gestation, she underwent an emergency cesarean section under general anesthesia for vaginal bleeding and an intrauterine infection. Soon after delivery, a massive hemorrhage was encountered while attempting to separate the placenta percreta from the bladder wall. Although total abdominal hysterectomy and partial cystectomy were performed, massive hemorrhaging persisted...
2014: Journal of Medical Investigation: JMI
J Teare, E Evans, A Belli, R Wendler
Placenta percreta is a complex obstetric condition and a cause of life-threatening peripartum haemorrhage. National guidelines advise preoperative placement of internal iliac artery occlusion balloon catheters in such cases to reduce haemorrhage, avoid caesarean hysterectomy and preserve fertility. Maternal complications of prophylactic occlusion balloon catheter insertion include puncture-site complications and arterial thrombosis, the signs of which are usually immediately clinically evident. Presentation of ischaemic nerve injury attributable to iliac artery thrombosis secondary to the presence of an occlusion balloon catheter is as yet unreported...
May 2014: International Journal of Obstetric Anesthesia
Verónica María de Jesús Ortega-Castillo, Salvador Espino y Sosa, Tomás Herrerías-Canedo
BACKGROUND: Obstetric hemorrhage is the second leading cause of maternal death in Mexico. Intrauterine tamponades are a valuable resource for the limitation of bleeding. OBJECTIVE: Analyze the success rate of the Bakri balloon in the control of obstetric hemorrhage and calculate the fill volume with clinical parameters. MATERIAL AND METHODS: Descriptive, retrospective and observational study Subjects were included who presented refractory hemorrhage on administration of uterotonics (postpartum, caesarean section, post-caesarean section, and post-miscarriage); a Bakri balloon was inserted with epidural anesthesia...
August 2013: Ginecología y Obstetricia de México
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