| Title: |
Anaesthesia Management in Case of Placenta Accreta undergoing Caesarean Delivery with Internal Iliac Artery Balloon Catheterisation and Embolisation. |
| Authors: |
PANDEY, MONICA1 monicapandey79@gmail.com, CHOPRA, SHIV MOHAN2, BANA, MONA2, AGRAWAL, MADHURI2 |
| Source: |
Journal of Clinical & Diagnostic Research. Aug2024, Vol. 18 Issue 8, p10-12. 3p. |
| Subject Terms: |
*CESAREAN section, *PLACENTA accreta, *ILIAC artery, *ERYTHROCYTES, *PLASMA products, *PERIPARTUM cardiomyopathy |
| Abstract: |
Abnormal invasion of the placenta into the uterine tissue during pregnancy is one of the most common causes of peripartum hysterectomy, as well as morbidity and mortality. A multidisciplinary approach is the best way to manage such cases in order to maintain perioperative haemodynamic stability, which leads to lower rates of complications and shorter hospital stays for both the parturient and the newborn. The authors hereby report the case of a 27-year-old female {Gravidity and Parity (G1P2)} at 36 weeks of gestation, diagnosed with central placenta accreta with bladder invasion. In the present case, authors performed a balloon-assisted caesarean delivery under general anaesthesia while avoiding hysterectomy. The patient had a history of a previous caesarean delivery 1.5 years prior. Placenta accreta was diagnosed during her ultrasound. All routine laboratory results were within the normal range, except for haemoglobin, which was 10.1 g/dL. An elective caesarean section with a consented hysterectomy under general anaesthesia was planned. Adequate blood and blood products (4 units of packed red blood cells and 2 units of fresh frozen plasma) were arranged before surgery. Bilateral internal iliac artery embolisation was performed to reduce perioperative bleeding. Flexible cystoscopy was conducted prior to surgery to confirm the extent of bladder invasion. The caesarean section was successfully carried out with the multidisciplinary team approach under general anaesthesia, and hysterectomy was not performed, allowing for a successful fertilitysparing caesarean delivery by our team. The patient was transferred to the Intensive Care Unit (ICU) after the surgery for proper vital monitoring and adequate pain management. She was moved to the ward on day 2 and discharged on day 3. In conclusion, balloon occlusion of the internal iliac artery is effective for haemostasis in most cases of patients with placenta previa. [ABSTRACT FROM AUTHOR] |
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