A case of placenta percreta with massive hemorrhage during cesarean section.
We describe a case of a 39-year-old woman diagnosed with placenta percreta complicated by massive hemorrhage during a cesarean section. At 27 weeks of gestation, she underwent an emergency cesarean section under general anesthesia for vaginal bleeding and an intrauterine infection. Soon after delivery, a massive hemorrhage was encountered while attempting to separate the placenta percreta from the bladder wall. Although total abdominal hysterectomy and partial cystectomy were performed, massive hemorrhaging persisted. Bleeding was finally controlled following bilateral internal iliac artery embolization. We used a cell salvage device and a rapid infuser for hemodynamics stabilization. Total blood loss was 47,000 mL, and anesthesia time was 12 h and 47 min. The patient was discharged on the 32(nd) postoperative day without major complications. Placenta accreta can be associated with life-threatening hemorrhage and it is vital to plan accordingly preoperatively.
Department of Anesthesiology, Tokushima University Hospital.
Katsuyoshi
K
Kume
Yasuo
Y
M Tsutsumi
Tomohiro
T
Soga
Yoko
Y
Sakai
Noriko
N
Kambe
Ryosuke
R
Kawanishi
Eisuke
E
Hamaguchi
Tomiya
T
Kawahara
Asuka
A
Kasai
Yoshimi
Y
Nakaji
Yousuke
Y
T Horikawa
Souichiro
S
Nakayama
Takashi
T
Kaji
Minoru
M
Irahara
Katsuya
K
Tanaka
D000328:Adult; D016063:Blood Loss, Surgical; D002585:Cesarean Section; D015653:Cystectomy; D004621:Embolization, Therapeutic; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006470:Hemorrhage / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007044:Hysterectomy; D010921:Placenta Accreta / Q000175:diagnosis / Q000628:therapy*; D011247:Pregnancy; D016896:Treatment Outcome