Successful Anesthesia Management of Massive Haemorrhage During C-Section Indicated of Placentapercreta Multidisciplinary Approach Based Team: A Case Report

Background: Placenta perccreta accounts for 7–10% of maternal mortality. Immature preoperative management and planning could increase the risk of maternal mortality. Anesthetic management during the procedure are involved due to high risk of massive hemorrhage. A multidisciplinary team approach is important to reduce risk during the procedure. The author reports the multidisciplinary approach in a placenta perccreta patient. Case Presentation Gestating woman aged 33 years with a gestational age 30–32 weeks canceled going to RSUD dr. Saiful Anwar Malang with complaints of bleeding from the birth canal for the past 1 month. The patient had a history of caesarean section in the lower segment. In the last 1 month, the patient has received a total of 6 RRC bags with antibiotics. Caesarean section (SC) to be performed due to the abnormal estimation of placental implantation from ultrasonography and gross hematuria. The patient was consulted for anesthesia 7 days before the scheduled SC. Calculation of the Placenta Accreta Index (PAI) score obtained a total score of 5. The patient underwent a Magnetic Resonance Imaging examination and found placenta previa type III (partial placenta previa) accompanied by placenta percreta, the impression of infiltrating the superoposterior wall of the urinary bladder. Preoperative management is carried out by involving a multidisciplinary team. Conclusion: Anesthetic management with a multidisciplinary team approach shows an effective and safe results in patients with placenta preccreta during a C-Section procedure. Hemodynamic monitoring is important during the procedure and need to be manage carefully.