Anaes SAQs · Obstetric anaesthesia
Anaesthesia for placenta accreta spectrum
Final-examination SAQ for placenta-accreta-spectrum.
On this page
Study tools
Target exams
Model answer
MDT planning (4). Tertiary centre; senior obstetricians, obstetric anaesthesia, neonatology, transfusion/haematology, IR if used, urology/ICU as needed; written surgical plan (likely caesarean hysterectomy); consent for transfusion/hysterectomy/GA conversion.[1][2]
Anaesthesia technique (3). Neuraxial start common with conversion readiness vs elective GA if extreme predicted loss/airway priority; arterial line and large-bore access before incision.[3]
Haemorrhage prep (4). MOH protocol, blood products immediately available, rapid infuser, warmer, cell salvage, TXA early when bleeding, calcium correction, viscoelastic testing if available.[4][3]
Crisis & postop (4). Do not forcibly remove adherent placenta; surgical control; balanced resuscitation; convert to GA if needed; ICU; VTE plan when safe.[2]
References4ShowHide
- [1]Jauniaux E, et al. FIGO consensus guidelines on placenta accreta spectrum disorders: Introduction. International Journal of Gynaecology and Obstetrics, 2018.PMID 29405322
- [2]Allen L, et al. FIGO consensus guidelines on placenta accreta spectrum disorders: Nonconservative surgical management. International Journal of Gynaecology and Obstetrics, 2018.PMID 29405317
- [3]Taylor NJ, Russell R Anaesthesia for abnormally invasive placenta: a single-institution case series. International Journal of Obstetric Anesthesia, 2017.PMID 28258943
- [4]WOMAN Trial Collaborators Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial. Lancet, 2017.PMID 28456509