Anesthetic management of two cases with placenta percreta that caused massive hemorrhage during cesarean section

We report the anesthetic management of two cases with placenta percreta that caused massive hemorrhage during cesarean section. These pregnant women, with a past history of cesarean section underwent elective operation after being diagnosed with total placenta previa and suspected adhesion of the placenta. The placenta percreta became evident after laparotomy and the patients underwent total hysterectomy after infant expulsion. They went into serious hemorrhagic shock, and recovered after the application of intensive cardiovascular support and blood transfusion. In recent years, the incidence of adhesion of the placenta has increased, but definitive, preoperative diagnosis is difficult; especially for the severe type: placenta percreta. Therefore, intensive management is necessary for the anesthesia of pregnant women with suspected adhesion of the placenta, including adequate preparation of transfused blood, since it might be difficult to save the mother's life after the onset of massive hemorrhage.