title: A Cesarean hysterectomy for invading placenta percreta: anesthetic safety considerations--a case report.
abstract: A 41-year-old woman presented to the surgical suite with an undiagnosed placenta percreta invading the bladder. The patient lost 16,000 mL of blood before the hemorrhage was surgically controlled, and a successful cesarean delivery, as well as a total abdominal hysterectomy, were performed. Ultimately, the patient was discharged 1 week later with a healthy baby. Unlike placenta accreta where the placenta strictly adheres to the musculature of the uterus, placenta percreta is a rare condition in which the placenta invades the full thickness of the myometrium and possibly other intra-abdominal organ structures. A review of the current literature yields recommendations for anesthetic management of this challenging and potentially life-threatening obstetric scenario. This case underlines the importance of a well-coordinated multidisciplinary approach to a complex condition.
authors.affiliation: St. Mary's Hospital, Bons Secours, West End Anesthesia Group, Richmond, Virginia , USA. dpfrasca1960@comcast.net
authors.forename: Daniel
authors.initials: D
authors.lastname: Frasca
mesh_terms: D000328:Adult; D000773:Anesthesia, Obstetrical / Q000379:methods*; D000776:Anesthesiology / Q000379:methods*; D002585:Cesarean Section / Q000379:methods*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D010921:Placenta Accreta / Q000601:surgery*; D011247:Pregnancy; D012307:Risk Factors; D016896:Treatment Outcome