Placenta accreta spectrum anaesthetic management with neuraxial technique can be facilitated by multidisciplinary groups

López-Erazo, Leidy Johanna; Sánchez, Beatriz; Blanco, Luisa Fernanda; Nieto-Calvache, Álbaro José

doi:10.4103/ija.ija_1216_20

Cited by 7 publications

(5 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There is no preferred primary mode of anesthesia for birth in PAS from a patient or health care professional perspective 9,15,16 . This study demonstrates that women value information, choice, and being informed of the risks and benefits of each option and would benefit from an antenatal anesthesiology consultation.…”

Section: Discussionmentioning

confidence: 85%

Anesthesia and postpartum pain management for placenta accreta spectrum: The patient perspective and recommendations for care

Bartels,

Lalor,

Walsh

et al. 2023

Intl J Gynecology & Obste

View full text Add to dashboard Cite

ObjectivePlacenta accreta spectrum (PAS) is a high‐risk complication of pregnancy, which often requires complex surgical intervention. There is limited literature on the patient experience during the perioperative period and postpartum pain management for PAS. Therefore, this study aims to explore the patient perspective of anesthesia care.MethodsEthical approval was granted by the hospital ethics committee (EC02.2023). This was a descriptive survey study, including women with a history of pregnancy complicated by PAS who were members of two patient advocacy groups. The survey, consisting of both open and closed questions, was performed over a 6‐week period between January and March 2023. Content analysis was performed on qualitative data to identify themes, and recommendations for care are suggested.ResultsA total of 347 participants responded to the survey; 76% (n = 252) had a cesarean hysterectomy (n = 252), and general anesthesia was the most common primary mode of anesthesia (39%, n = 130). We identified two overarching themes: experiences of anesthesia and experience of postpartum pain management. Under experiences of anesthesia, three subthemes were identified, namely “communication with the anesthesiologist”, “deferring to the expertise of the team”, and “consequences of decision around the mode of anesthesia.” Under postpartum pain management, two subthemes emerged: “support of specialist PAS team” and “poor pain management following PAS surgery”.ConclusionsWomen want to be involved in decisions around their care, but do not always understand the consequences of their decision‐making, such as missing the birth of their child. An antenatal anesthesiology consultation is important to provide women with information, explore preferences, and develop a plan of care for the birth.

show abstract

Section: Discussionmentioning

confidence: 85%

Anesthesia and postpartum pain management for placenta accreta spectrum: The patient perspective and recommendations for care

Bartels,

Lalor,

Walsh

et al. 2023

Intl J Gynecology & Obste

View full text Add to dashboard Cite

show abstract

“…Each mode of anesthesia is associated with risks and benefits. Neuraxial anesthesia facilitates the mother to be awake for the birth with her support partner with her, has minimal effect on uterine tone, avoids fetal exposure to anesthetic agents, and typically facilitates postoperative pain control through use of an epidural infusion or intrathecal opioids 8,20 . However unplanned conversion to GA may be needed in the event of an emergency and the block may be inadequate for the duration of the procedure 14 …”

Section: Discussionmentioning

confidence: 99%

“…14 General anesthesia, on the other hand, is associated with a higher risk of hemorrhage and risk of failed intubation. 21,22 Furthermore, the fetus is exposed to anesthetic agents, although a single, brief exposure to GA is unlikely to affect neurodevelopmental outcomes for the child. 23,24 The benefit of GA is a secured airway from the start of the procedure, and optimal comfort for the mother.…”

Section: Overarching Theme: Healthcare Provider Experience Of Anesthe...mentioning

confidence: 99%

Anesthesia and postpartum pain management for placenta accreta spectrum: The healthcare provider perspective

Bartels,

Walsh,

Nieto‐Calvache

et al. 2023

Intl J Gynecology & Obste

View full text Add to dashboard Cite

ObjectiveTo explore the management and experiences of healthcare providers around anesthetic care in placenta accreta spectrum (PAS).MethodsThis descriptive survey study was carried out over a 6‐week period between January and March 2023. Healthcare providers, both anesthesiologists and those involved in operative care for women with PAS, were invited to participate. Questions invited both quantitative and qualitative responses. Qualitative responses were analyzed using content analysis.ResultsIn all, 171 healthcare providers responded to the survey, the majority of whom were working in tertiary PAS referral centers (153; 89%) and 116 (70%) had more than 10 years of clinical experience. There was variation in the preferred primary mode of anesthesia for PAS cases; 69 (42%) used neuraxial only, but 58 (35%) used a combined approach of neuraxial and general anesthesia, with only 12 (8%) preferring general anesthesia. Ninety‐nine (61%) were offering a routine antenatal anesthesia consultation. Content analysis of qualitative data identified three main themes, which were “variation in approach to primary mode of anesthesia”, “perspectives of patient preferences”, and “importance of multidisciplinary team care”. These findings led to the development of a decision aid provided as part of this paper, which may assist clinicians in counseling women on their options for care to come to an informed decision.ConclusionsApproach to anesthesia for PAS varied between healthcare providers. The final decision for anesthesia should take into consideration the clinical care needs as well as the preferences of the patient.

show abstract

“…Placenta accreta refers to the condition of the placenta that has an abnormal attachment to the uterus, which is divided into three based on the histological degree of placental invasion into the myometrium (accreta, increta, and percreta) (1)(2)(3). Placenta accreta is one of the two most common causes of peripartum hemorrhage and the most common indication for peripartum hysterectomy, the main mistakes often made in this case are mainly failure to make the right diagnosis and late medical and surgical treatment (4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

“…The choice of anesthesia technique between regional and general is crucial to minimize risks to the mother and fetus who will undergo cesarean section surgery. (2,(6)(7)(8)Appropriate transfusion protocols are also important in the management of patients with accreted placenta (9)(10)(11). The following is a case report of a patient with an accreta placenta with an accreta placenta index score of 9, who will undergo cesarean section.…”

Section: Introductionmentioning

confidence: 99%

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

Kurniajaya,

Aribawa,

Hartawan

et al. 2024

International Journal of Scientific Advances

View full text Add to dashboard Cite

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.

show abstract

Placenta accreta spectrum anaesthetic management with neuraxial technique can be facilitated by multidisciplinary groups

Cited by 7 publications

References 11 publications

Anesthesia and postpartum pain management for placenta accreta spectrum: The patient perspective and recommendations for care

Anesthesia and postpartum pain management for placenta accreta spectrum: The patient perspective and recommendations for care

Anesthesia and postpartum pain management for placenta accreta spectrum: The healthcare provider perspective

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

Contact Info

Product

Resources

About