Management of massive hemorrhage in pregnant women with placenta previa

Park, Hee Sun; Cho, Hyun‐Seok

doi:10.17085/apm.20076

Cited by 23 publications

(19 citation statements)

References 57 publications

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“…Generally, FFP transfusion is part of the massive transfusion protocol and should be considered if coagulopathy is suspected or con rmed by laboratory tests. The bene ts of transfusion of blood components and coagulation factors according to the massive transfusion protocol are the prevention of transfusion delay and coagulopathy correction [10].…”

Section: Discussionmentioning

confidence: 99%

Successful Anesthesia Management of Massive Haemorrhage During C-Section Indicated of Placentapercreta Multidisciplinary Approach Based Team: A Case Report

Shantikaratri,

Pankao,

Hartono

2023

Preprint

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Background Placenta perccreta accounts for 7–10% of maternal mortality. Immature preoperative management and planning could increase the risk of maternal mortality. Anesthetic management during the procedure are involved due to high risk of massive hemorrhage. A multidisciplinary team approach is important to reduce risk during the procedure. The author reports the multidisciplinary approach in a placenta perccreta patient. Case Presentation Gestating woman aged 33 years with a gestational age 30–32 weeks canceled going to RSUD dr. Saiful Anwar Malang with complaints of bleeding from the birth canal for the past 1 month. The patient had a history of caesarean section in the lower segment. In the last 1 month, the patient has received a total of 6 RRC bags with antibiotics. Caesarean section (SC) to be performed due to the abnormal estimation of placental implantation from ultrasonography and gross hematuria. The patient was consulted for anesthesia 7 days before the scheduled SC. Calculation of the Placenta Accreta Index (PAI) score obtained a total score of 5. The patient underwent a Magnetic Resonance Imaging examination and found placenta previa type III (partial placenta previa) accompanied by placenta percreta, the impression of infiltrating the superoposterior wall of the urinary bladder. Preoperative management is carried out by involving a multidisciplinary team. Conclusion Anesthetic management with a multidisciplinary team approach shows an effective and safe results in patients with placenta preccreta during a C-Section procedure. Hemodynamic monitoring is important during the procedure and need to be manage carefully.

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Section: Discussionmentioning

confidence: 99%

Successful Anesthesia Management of Massive Haemorrhage During C-Section Indicated of Placentapercreta Multidisciplinary Approach Based Team: A Case Report

Shantikaratri,

Pankao,

Hartono

2023

Preprint

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“…The results of an ultrasound examination conducted on March 1, 2021, showed that the mother had lateral placenta previa. Ultrasound examination is the main method recommended for detecting the location of abnormal placental implantation in the prenatal period, this examination is very important to make a proper diagnosis and determine the next management (Park and Cho, 2020). Speculum examination of digital vaginal examination is no longer recommended to diagnose placenta previa because it can cause massive bleeding (Merriam and D'Alton, 2017a).…”

Section: Discussionmentioning

confidence: 99%

Preterm Multigravida With a Lateral Placenta Previa and Chronic HBV : Case Study

Tarsikah

Oktaviani

2022

MIKIA

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Pregnancy is a physiological phenomenon, but this phase is a critical period that can lead to complications and high-risk conditions. Placenta previa is one of the most common causes of antepartum hemorrhage, we here report such a case with accompanying complications and preparation for the correct treatment management. This case study was carried out through anamnesis, physical examination and laboratory assessment. The instrument in this study was used screening sheet for pregnant women. The results of the study showed that a patient aged 35 years with gravida 6, para 4, abortion 1, 34-35 weeks gestation, 2 times history of caesarean section (CS), experienced painless spotting bleeding, Hb: 10.4gr%, and HbsAg: positive, breech presentation, with a lateral placenta previa. The management that has been carried out is interprofessional collaboration for referrals to advanced health facilities for monitoring of placenta previa, planning for delivery, corticosteroid therapy for fetal lung maturation, HBsAg serologic examination, and provision of vaccines to prevent mother-to-child transmission (MTCT). The quality of antenatal care (ANC) can reduce the morbidity and mortality risk significantly, because adequate management preparation, interprofessional collaboration, the availability of blood transfusions, operative procedures, Intensive Unit Care (ICU), and adequate neonatal facilities can improve the prognosis of pregnancy’s complication cases.

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“…Postpartum hemorrhage is frequently seen in maternal deaths and is a life-threatening phenomenon. In many studies, the anesthesiologist's approach, blood product transfusion, management, choice of ideal anesthetic manner, and postoperative care in life-threatening major bleeding cases have been examined [12,13]. In these studies, no superiority over the other has been stated, and inferences can be made at the recommendation level.…”

Section: Discussionmentioning

confidence: 99%

Anesthesia management in patients with abnormally invasive placenta: A single-center experience

Yıldız

ÇETİNEL

Marangoz

et al. 2022

Archives of Clinical and Experimental Medicine

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Aim: Postpartum hemorrhage is a life-threatening obstetric emergent clinical situation accompanied by blood loss of more than 500 ml after vaginal delivery and more than 1000 ml after cesarean section. This situation, frequently encountered in placental adhesion anomalies, is essential in terms of follow-up, treatment, and multidisciplinary management. We aimed to retrospectively evaluate the perioperative anesthesia management, transfusion requirement, and postoperative intensive care unit requirement of patients diagnosed with placental invasion anomaly who had an intraoperative hemorrhage Methods: In our single-center study, a total of 58 female patients diagnosed with of placental invasion anomaly with a cesarean section between 2017-2020 were examined. Patients under 18 years of age and missing data were excluded from the study. Demographic data of patients (age, American Society of Anesthesiologists score (ASA)), diagnosis, duration of operation, perioperative laboratory findings, anesthesia type, perioperative hemodynamics (highest heart rate, lowest mean arterial pressure, shock index), amount of bleeding, blood products, and fluids used, surgical interventions (B-Lynch, Bacri balloon application, uterine artery ligation, hysterectomy), intraoperative vasopressor/inotrope use, ICU stay, laboratory results in the first 24 hours postoperatively, and total hospital stay were recorded. Results: In the preoperative evaluation, 27 (46.5%) patients were diagnosed with placenta accreta, and placenta previa was diagnosed in 19 (32.7%) patients. Perioperatively mean of 3.08 ± 1.7 units of Red blood cell was used. In patients with postoperative intensive care unit hospitalization, the highest intraoperative lactate value was 3.5±1.8 mmol/L, shock index was 1.3±0.3 (0.6-1.8). In patients given intraoperative fibrinogen concentrate, the intraoperative shock index was 1.5±0.2 (0.9-1.8), the amount of intraoperative bleeding was 2575±302.2 ml, and the fibrinogen levels measured in the first 24 hours after surgery were 294.7±79.7 mg/dl. Conclusions: Anesthesia management of patients diagnosed with abnormal placental invasion is important because of significant hemorrhage. Due to unstable hemodynamics, preoperative blood product preparation with a multidisciplinary approach and a postoperative intensive care unit plan should be made for these patients.

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Management of massive hemorrhage in pregnant women with placenta previa

Cited by 23 publications

References 57 publications

Successful Anesthesia Management of Massive Haemorrhage During C-Section Indicated of Placentapercreta Multidisciplinary Approach Based Team: A Case Report

Successful Anesthesia Management of Massive Haemorrhage During C-Section Indicated of Placentapercreta Multidisciplinary Approach Based Team: A Case Report

Preterm Multigravida With a Lateral Placenta Previa and Chronic HBV : Case Study

Anesthesia management in patients with abnormally invasive placenta: A single-center experience

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