Anesthetic Management in Obese Patients with Placenta Accreta Undergoing Cesarean Section: Case Report

Abstract

Background: Placenta accreta is a condition of abnormal attachment of the placenta that could cause massive bleeding complications and increase mortality in patients. Proper anesthetic management and transfusion protocol are required for the patient. Case: A patient with placenta previa total with Placenta accreta Index score is 9 and obesity. The patient is planned to have a cesarean section followed by a total hysterectomy. For anesthetic management, general anesthesia was performed with the insertion of an endotracheal tube as an anticipatory for massive bleeding in this patient. Total bleeding during the operation was 2100 ml, and two bags of Packed Red Cells (PRC) were transfused during the operation. Postoperatively, the patient underwent treatment in the intensive care unit for one day to stabilize his general condition before being transferred to the regular ward. The patient was discharged after 2 days of treatment in the ward. Conclusion: that case can be drawn from this case is the importance of early detection of patients with a high risk of Placenta accreta, so that early treatment and comprehensive preparation can be carried out before termination is done.