Perioperative anaesthetic approach for placenta accreta cases (a retrospective analysis) [Plasenta akreta vakalarinda peri̇operati̇f anestezi̇ yaklaşimi (retrospecti̇f anali̇z)]

Objective: we aimed to investigate anaesthetic approach,transfusion requirements and perioperative problems in terms of major obstetric hemorrhage presence in cesarean section patients operated and diagnosed with placenta accreta at our hospital. methods: antenatal diagnosis,operation timing (day/night),anaesthesia type (general/regional),operation duration,surgical operations other than hysterectomy,peroperative hemodynamics,ketamine,vasopressor,oxytocine,crystalloid,colloid and central venous cannulation requirements were noted in parturients diagnosed with placenta accreta/percreta between 2007-2011. perioperative red blood cell (rbc),fresh frozen plasma,platelet transfusion,lowest peroperative hemoglobin level,as well as hemoglobin concentration,platelet count,activated partial thromboplastin time,prothrombin time at hospital entry were recorded. extubation location,intensive care stay and duration of mechanical ventilation,length of hospital stay,in-hospital mortality and newborn data were evaluated. the presence of major obstetric hemorrhage was determined as primary outcome and patients were compared in two groups: patients transfused less than five units of rbc (es<5u group) and patients transfused equal or more than five units of rbc (es> 5u group). results: placenta percreta was documented in thirteen out of 74 cases. rbc transfusion was 2 (0-4) in es< 5u and 7.5 (5-21) in es> 5u groups. operation time was longer,bladder repair,peroperative hypotension,ketamine and vasopressor requirements were more frequent in es> 5 u group. similarly blood products and fluid consumed were higher in es≥ 5u. conclusion: cases with placental invasion abnormalities must be considered more complicated than routine cesarean section and anaesthesiologists must be prepared for dynamic anaesthesia care and transfusion requirements.