Perioperative Outcomes, Risks and Complications Associated with Placenta Previa and Placenta Accreta Spectrum Revisited From an Anesthesiology Perspective

Abstract

Purpose: Placenta previa (PP) and placenta accreta spectrum are forms of abnormal placentation, and they are associated with significant perinatal morbidity and mortality. The objective of the present study was to juxtapose the baseline data, clinical features, perioperative outcomes, risks, and complications associated with PP and placenta accreta spectrum. Materials and Methods: This retrospective study was performed using data extracted from the medical files of a total of 300 patients diagnosed with PP (Group I, n=237) and placenta accreta spectrum (Group II, n=63). The information gathered for every patient consisted of baseline descriptives, perinatal data and need for intraoperative or postoperative blood transfusion, pre- and postoperative serum levels of hemoglobin, fibrinogen and C-reactive protein, need and duration for intensive care unit stay, whether hemodialysis and mechanical ventilation were employed. Results: The body-mass index was remarkably higher in Group II (p=0.002). There was no statistically significant difference between two groups concerning baseline descriptive data and perinatal, perioperative, and postoperative variables. Conclusion: Results of the present study demonstrated that despite adequate planning and optimal management strategies; the likelihood of significant morbidity and mortality associated with PP and placenta accrete spectrum is still remarkable. Early and close monitoring with careful preparation is momentous for antepartum and intrapartum management. Additional research is essential to determine the predisposing factors as well as ideal methods of diagnosis, treatment, and prevention.