SEZARYEN UYGULANAN PLASENTA PREVİA VE/VEYA PLASENTA İMPLANTASYON ANOMALİLERİNDE ANESTEZİ YÖNETİMİ: TEK MERKEZLİ DENEYİM

Amaç: Bu retrospektif çalışmanın amacı, plasentasyon anomalisi olan olguları gözden geçirmek, morbidite ve mortaliteyietkileyen prognostik faktörleri belirlemek ve anestezik yönetim stratejisini değerlendirmektir.Yöntem: Bu çalışmada, hastanemizde plasenta previa ve/veya plasentasyon anomalisi nedeni ile sezaryen uygulanan hastalarınbilgisayar sistemindeki kayıtları incelendi. Hastaların demografik verileri, obstetrik özellikleri, cerrahi prosedür, anestezi tekniği,kan transfüzyonu ve komplikasyonları kaydedildi.Bulgular: Toplam 76 hasta çalışmaya dahil edildi. Plasenta previa ve/veya plasentasyon anomalisi bulunan hastaların%87'sine genel anestezi, %13'üne rejyonal anestezi uygulandı. Hastaların 47'sinde plasenta previa, 15'inde plasenta acreata,14'ünde plasenta perkreata tanısı mevcut olup 14 hastaya sezaryen histerektomi yapıldı. Bir hasta entübe, iki hasta ekstübe olmaküzere toplam üç hasta ileri takip için yoğun bakım ünitesine devredildi. Postoperatif dönemde bir hastada maternal mortalitetespit edilmiş olup diğer tüm hastaların taburcu edildiği belirlendi.Sonuç: Plasenta previa ve/veya plasenta implantasyon anomalileri için anestezi uygulamaları kanama yönetimi ve diğerdestekleyici tedavi stratejilerini içerir. Bu hastalarda kanama riski nedeniyle ağırlıklı olarak genel anestezi ve plasentasyonanomalisi bulunmayan hastalarda ise rejyonel anestezi güvenle uygulanabilir

ANESTHESIA MANAGEMENT OF PATIENTS WHO HAD CAESAREAN SECTION WITH PLACENTA PREVIA AND/OR PLACENTA IMPLANTATION ANOMALY: A SINGLE CENTER EXPERIENCE

Objective: The aim of this retrospective study was to review patients who have placentation anomalies and determine theprognostic factors effective on morbidity and mortality and to evaluate the strategy of anesthetic management.Method: In this study, the records of the patients in the computer system of our hospital who underwent cesarean section forplacenta previa and / or placentation anomaly were examined. Patients demographic data, obstetric characteristics, surgicalprocedure, anesthesia technique, blood transfusion and complications were recorded.Results: A total of 76 patients were included in the study. 87% of patients with placenta previa and/or placentation anomalyhad general anesthesia and 13% had neuroaxial anesthesia. Placenta previa in 47 patients, placenta acreata in 15 patients, placentapercreata in 14 patients and cesarean hysterectomy were performed in 14 patients. A total of three patients (1 patient entubated, 2patients ekstübated) were transferred to the intensive care unit for further follow-up. Maternal mortality was determined in onepatient, all other patients were discharged in postoperative period.Conclusion: Anesthesia applications for placenta previa and / or placenta implantation anomalies include bleeding managementand other supportive treatment strategies. Predominantly general anesthesia is preferred due to the risk of bleeding in these patients.However regional anesthesia can be safely performed in patients without placentation anomalies

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