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Cesarean Hysterectomy and Placenta Accreta Spectrum

Anesthesia Implications

Clinically reviewed by anesthesia providers · Updated

Position : Supine, left uterine displacement, arms extended
Time : 2-4 hours (long)
Blood Loss : Very High (500+ ml)
Post-op Pain : High (7-10)
Maintenance Paralytic : Yes
Blocks : TAP, Quadratus Lumborum
Considerations : Pregnancy / Obstetric, High Blood Loss, Aspiration risk / Full stomach, Arterial line, Central line, Neonatal resuscitation / NICU standby, Fluoroscopy / Xray, Breastfeeding, PONV, Anticoagulation / Antiplatelet Therapy

Anesthetic Approaches

1GETT
2CSE
3Spinal
The Surgery

Antenatal diagnosis - Ultrasound, often with MRI , defines the depth of invasion and whether the bladder or parametrium is involved. A suspected accreta is scheduled rather than stumbled into:...

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