title: Management of Neuraxial Anaesthesia for Emergent Caesarean Section for Placenta Previa.
abstract: Abnormal placental attachments, such as placenta accreta, increta or percrata, can result in increased morbidity and mortality because of the risk of severe postpartum haemorrhage. We aimed to present the management of spinal anaesthesia and surgical approach for emergent caesarean section because of vaginal bleeding in a multiparous pregnant woman with placenta previa at 36 weeks' gestation. Hyperbaric bupivacaine 12 mg, fentanyl 10 μg and morphine 150 μg were intrathecally administered for spinal anaesthesia. Oxytocin, methyl ergonovin and tranexamic acid were administered after umbilical cord clamping. Breech delivery of the baby was provided by a vertical incision to the uterus for avoiding placental harm. Subtotal hysterectomy was performed leaving the placenta in situ. Two units of red blood cells were transfused during the operation, lasting approximately 40 min. The patient was uneventfully discharged on the postoperative fourth day. In conclusion, a single-shot spinal anaesthesia was successfully maintained without conversion to general anaesthesia until the end of the hysterectomy in the patient in whom placenta increta was observed during caesarean delivery.
authors.affiliation: Department of Anaesthesiology, Gazi University School of Medicine, Ankara, Turkey.
authors.forename: Berrin
authors.initials: B
authors.lastname: Günaydın
authors.affiliation: Department of Gynecology and Obstetrics, Gazi University School of Medicine, Ankara, Turkey.
authors.forename: Mertihan
authors.initials: M
authors.lastname: Kurdoğlu
authors.affiliation: Department of Gynecology and Obstetrics, Gazi University School of Medicine, Ankara, Turkey.
authors.forename: İsmail
authors.initials: İ
authors.lastname: Güler
authors.affiliation: Department of Anaesthesiology, Gazi University School of Medicine, Ankara, Turkey.
authors.forename: Mehrnoosh
authors.initials: M
authors.lastname: Bashiri
authors.affiliation: Department of Gynecology and Obstetrics, Gazi University School of Medicine, Ankara, Turkey.
authors.forename: Fırat
authors.initials: F
authors.lastname: Büyüktaşkın
authors.affiliation: Department of Gynecology and Obstetrics, Gazi University School of Medicine, Ankara, Turkey.
authors.forename: Mine Dağgez
authors.initials: MD
authors.lastname: Keleşoğlu
authors.affiliation: Department of Anaesthesiology, Gazi University School of Medicine, Ankara, Turkey.
authors.forename: Gözde
authors.initials: G
authors.lastname: İnan
keywords: Abnormal placental attachment; caesarean; placenta increta; placenta previa; spinal anaesthesia