A challenging case of placenta accreta spectrum with known seizure disorder planned for cesarean hysterectomy

A 28-year-old female with amenorrhea of 25 weeks G2P1L1, diagnosed case of placenta previa and placenta accreta with previous lower-segment cesarean section and ventriculomegaly in the fetus was planned for hysterotomy ± hysterectomy. Optimization of anticipated bleeding during surgical procedure was done with prior uterine artery embolization and a multidisciplinary care team for the management of the placenta accreta spectrum keeping general anesthesia as the choice. The role of strictly monitoring blood pressure invasively is critical in ensuring hemodynamic stability. In addition, quick access to a blood bank capable of employing massive transfusion protocols is essential. This approach allowed the maintenance of stable hemodynamics with an uneventful surgical course.