Anesthetic management of placenta accreta spectrum requires meticulous preparation and a multidisciplinary approach to optimize maternal and fetal outcomes.
Anesthetic challenges in placenta accreta spectrum demand specialized protocols; leaves open optimal techniques pending higher-level evidence.
Placenta accreta spectrum is becoming more common and is the most frequent indication for peripartum hysterectomy. Management of cesarean delivery in the setting of a morbidly adherent placenta has potential for massive hemorrhage, coagulopathies, and other morbidities. Anesthetic management of placenta accreta spectrum presents many challenges including optimizing surgical conditions, providing a safe and satisfying maternal delivery experience, preparing for massive hemorrhage and transfusion, preventing coagulopathies, and optimizing postoperative pain control. Balancing these challenging goals requires meticulous preparation with a thorough preoperative evaluation of the parturient and a well-coordinated multidisciplinary approach in order to optimize outcomes for the mother and fetus.
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Warrick et al. (2018) studied this question.
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