ABSTRACT
The management of placenta accreta is complicated and requires the orchestration of numerous moving parts: multiple patients, multiple locations, multiple specialists, and multiple procedures. Once a patient with placenta accreta is identified, scheduling an anesthesia consultation and multidisciplinary clinical care conference is paramount to ensuring a safe and successful delivery. This chapter presents an obstetrical anesthesiologist's perspective and approach to the highly complex cases. Surgical history, including prior cesarean sections and other abdominal surgeries, add complexity to an already challenging case and may affect the choice of anesthetic. The choice of anesthetic technique is made on an individual basis determined by the anesthesiologist's judgment with special consideration for maternal, fetal, and obstetrical factors. The choice of anesthetic is made on case-by-case basis. Factors that play into the decision between a general and regional anesthetic include patient characteristics, extent of placental invasion, surgical technique, and practitioner preference.
