015 Placenta percreta perioperative and anaesthetic management

(*Fictitious case)

You are contacted by the ultrasound department – they have just completed a formal scan on an urgent referral and want to discuss their findings with you urgently. A 34yr old woman was admitted overnight with some PV bleeding at 32 weeks. She has had 2 previous caesareans and on the scan they have found a low lying anterior placenta which overlies the previous scar and concerningly there appears to be ultrasonographic evidence of accreta (vascular lacunae) and possibly doppler evidence of large vessels indicating invasion of the bladder (percreta).

This condition quite rightly strikes fear into the heart of surgeon and anaesthetist alike – primarily because of the risk of catastrophic torrential haemorrhage.

What are the principles of managing someone with placenta percreta?

Hi Everyone,

This week on the podcast I am joined again by my Colleague Graeme Johnson where we discuss the perioperative and anaesthetic management of the patient with a morbidly adherent placenta.

Useful links:

Manual Aortic compression:

Screencast of presentation on this topic at Dept Anaesthesia Meeting:





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