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Review
. 2025 Jun 1;68(2):275-282.
doi: 10.1097/GRF.0000000000000921. Epub 2024 Dec 11.

Anesthetic Considerations and Blood Utilization for Placenta Accreta Spectrum

Philip E Hess  1 , Yunping Li
Affiliations
Review

Anesthetic Considerations and Blood Utilization for Placenta Accreta Spectrum

Philip E Hess et al. Clin Obstet Gynecol. .

Abstract

The anesthetic management of the patient with placenta accreta spectrum begins before surgery by assessing the patient and their comorbidities and providing psychological preparation for the perioperative period. Choosing neuraxial or general anesthesia for surgery balances the procedure's clinical needs with the patient's desires. Intraoperatively, management of homeostasis during acute blood loss requires assessments of central volume to avoid over-transfusion. Viscoelastic testing may be useful to assess coagulation to target the replacement of coagulation factors. Postoperative care is an essential continuum of the procedure, and the availability of bedside ultrasound can aid rapid decision-making.

Keywords: anesthesia; obstetric anesthesia; obstetric hemorrhage; placenta accreta; point-of-care ultrasound; viscoelastic testing.

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References

    1. Warrick CM, Markley JC, Farber MK, et al. Placenta accreta spectrum disorders: knowledge gaps in anesthesia care. Anesth Analg. 2022;135:191–197.
    1. Shamshirsaz AA, Fox KA, Salmanian B, et al. Maternal morbidity in patients with morbidly adherent placenta treated with and without a standardized multidisciplinary approach. Am J Obstet Gynecol. 2015;212:218 e1–218 e9.
    1. Bartels HC, Walsh D, Nieto-Calvache AJ, et al. Anesthesia and postpartum pain management for placenta accreta spectrum: The healthcare provider perspective. Int J Gynaecol Obstet. 2024;164:964–970.
    1. Sandlin AT, Magann EF, Whittington JR, et al. Management of pregnancies complicated by placenta accreta spectrum utilizing a multidisciplinary care team in a rural state. J Matern Fetal Neonatal Med. 2022;35:5964–5969.
    1. Yao R, Nguyen HY, Hong L, et al. Regional multidisciplinary team approach to the management of placenta accreta spectrum disorder. J Matern Fetal Neonatal Med. 2023;36:2190840.