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Management of massive hemorrhage in pregnant women with placenta previa

Anesthesia and Pain Medicine 2020년 15권 4호 p.409 ~ 416
박희선, 조현석,
소속 상세정보
박희선 ( Park Hee-Sun ) - University of Ulsan College of Medicine Asan Medical Center Department of Anesthesiology and Pain Medicine
조현석 ( Cho Hyun-Seok ) - University of Ulsan College of Medicine Asan Medical Center Department of Anesthesiology and Pain Medicine

Abstract


Patients with placenta previa are at risk for intra- and postpartum massive blood loss as well as increased risk of placenta accreta, a type of abnormal placental implantation. This condition can lead to serious obstetric complications, including maternal mortality and morbidity. The risk factors for previa include prior cesarean section, multiparity, advanced maternal age, prior placenta previa history, prior uterine surgery, and smoking. The prevalence of previa parturients has increased due to the rising rates of cesarean section and advanced maternal age. For these reasons, we need to identify the risk factors for previa and identify adequate management strategies to respond to blood loss during surgery. This review evaluated the diagnosis of placenta previa and placenta accreta and assessed the risk factors for previa-associated bleeding prior to cesarean section. We then presented intraoperative anesthetic management and other interventions to control bleeding in patients with previa expected to experience massive hemorrhage and require transfusion.

키워드

Balloon occlusion; Cesarean section; Obstetrical anesthesia; Placenta accreta; Placenta previa; Postpartum hemorrhage; Uterine artery embolization

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