RETROSPECTIVE ANALYSIS OF ANESTHETIC APPROACHES IN CESAREAN DELIVERIES INVOLVING PLACENTAL ANOMALIES

Abstract

Objective: Placental anomalies such as placenta previa and placenta accreta spectrum disorders pose significant challenges during cesarean deliveries due to the increased risk of massive obstetric hemorrhage. Optimal anesthetic management is crucial to enhance maternal and fetal outcomes in these high-risk situations.

Methods: A retrospective observational study was conducted at Gulbarga Institute of Medical Sciences, Kalaburagi, from January 2023 to January 2024. Sixty pregnant women diagnosed with placental anomalies were divided into two groups: Group P (n = 42) with placenta previa and Group A (n = 18) with placenta accreta spectrum disorders. Data on demographics, anesthetic techniques, intraoperative parameters, and postoperative outcomes were collected and analyzed using statistical methods appropriate for continuous and categorical variables.

Results: General anaesthesiology was administered more frequently in group a (96.4%) compared to group p (74.6%) (p = 0.009). Group A had a significantly longer duration of surgery s (80.53±26.02 min vs. 52.43±13.34 min, p < 0.001) and greater estimated blood loss (1582.14±790.71 ml vs. 685.82±262.82 ml, p < 0.001). They also required more blood transfusions and had longer durations of mechanical ventilation (75.14±43.84 hours vs. 4.74±20.78 hours, p < 0.001) and ICU stays (2.80±1.13 days vs. 0.50±1.10 days, p < 0.001).

Conclusion: Patients with placenta accreta spectrum disorders face higher intraoperative and postoperative risks compared to those with placenta previa. General anaesthesiology is often preferred in these cases due to the potential for massive hemorrhage. Individualized anesthetic plans are essential to manage the increased perioperative challenges effectively.