Retrospective evaluation of 10-year anesthesia management in patients with placenta acreata spectrum and placenta previa

Introduction and Objective: The increasing number of cesarean sections in our country and in the world and due to the increasing spectrum of placenta accreta and pregnant women with a diagnosis of placenta previa can frequently come before anesthesiologists. In this study, anesthesia management of 631 cases with a diagnosis of placenta accreta spectrum disorder and placenta previa who had undergone cesarean section between January 2010 and December 2020 in Dicle University Medical Faculty Hospitals were examined and the results were evaluated in the highlights of the literature. Materials and Methods: Age, gestational age, gravida, parity, previous cesarean section number, anesthesia method applied, preoperative hemoglobin, platelet counts and postoperative hemoglobin values of 631 patients included in the study were recorded. Transfusion applications (erythrocyte suspension, fresh frozen plasma), use of colloid, tranexamic acid, and fibrinogen concentrate were recorded. Complications that developed in the peroperative period (DIC, ARF), length of stay in the tertiary intensive care unit and whether mortality developed or not were reported. Results: It was determined that general anesthesia was preferred in 40.1% of the cases, spinal anesthesia was preferred in 59.9% of the cases, and maternal mortality was not observed. The rate of need for tertiary intensive care in pregnant women who underwent general anesthesia was 9.9%, and the rate was 0.8% in pregnant women who underwent spinal anesthesia. Blood product and fibrinogen concentrate needs of pregnant women who received general anesthesia were found to be significantly higher than those who received spinal anesthesia. Conclusion: In our study, it was observed that general anesthesia was preferred more in patients with an emergency, high probability of bleeding and hysterectomy indication. There was no mortality in the pregnant women included in our study. It was found that the need for more blood products and the need for tertiary intensive care in the general anesthesia group. We think that spinal anesthesia should be preferred over general anesthesia in suitable patients. Keywords: Spectrum Disorder of Placenta Accreta, Placenta Previa, Anesthesia management, Transfusion of blood products, Need for intensive care.