{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T15:30:49Z","timestamp":1782833449142,"version":"3.54.5"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,10,19]],"date-time":"2021-10-19T00:00:00Z","timestamp":1634601600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,10,19]],"date-time":"2021-10-19T00:00:00Z","timestamp":1634601600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Anesthesiol"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>The incidence of placenta preiva is rising. Cesarean delivery is identified as the only safe and appropriate mode of delivery for pregnancies with placenta previa. Anesthesia is important during the cesarean delivery. The aim of this study is to assess maternal and neonatal outcomes of patients with placenta previa managed with neuraxial anesthesia as compared to those who underwent general anesthesia during cesarean delivery.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A retrospective cohort study was performed of all patients with placenta preiva at our large academic institution from January 1, 2014 to June 30, 2019. Patients were managed neuraxial anesthesia and general anesthesia during cesarean delivery.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>We identified 1234 patients with placenta previa who underwent cesarean delivery at our institution. Neuraxial anesthesia was performed in 737 (59.7%), and general anesthesia was completed in 497 (40.3%) patients. The mean estimated blood loss at neuraxial anesthesia of 558.96\u2009\u00b1\u200942.77\u2009ml were significantly lower than the estimated blood loss at general anesthesia of 1952.51\u2009\u00b1\u2009180\u2009ml (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). One hundred and forty-six of 737 (19.8%) patients required blood transfusion at neuraxial anesthesia, whereas 381 out of 497 (76.7%) patients required blood transfusion at general anesthesia. The rate neonatal asphyxia and admission to NICU at neuraxial anesthesia was significantly lower than general anesthesia (2.7% vs. 19.5 and 18.2% vs. 44.1%, respectively). After adjusting confounding factors, blood loss was less, Apgar score at 1- and 5-min were higher, and the rate of blood transfusion, neonatal asphyxia, and admission to NICU were lower in the neuraxial group.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Our data demonstrated that neuraxial anesthesia is associated with better maternal and neonatal outcomes during cesarean delivery in women with placenta previa.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12871-021-01472-w","type":"journal-article","created":{"date-parts":[[2021,10,19]],"date-time":"2021-10-19T04:50:42Z","timestamp":1634619042000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Anesthetic management in cesarean delivery of women with placenta previa: a retrospective cohort study"],"prefix":"10.1186","volume":"21","author":[{"given":"Dazhi","family":"Fan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaming","family":"Rao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongxin","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huishan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zixing","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gengdong","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pengsheng","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengying","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuping","family":"Ye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoling","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengping","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,10,19]]},"reference":[{"key":"1472_CR1","doi-asserted-by":"publisher","first-page":"654","DOI":"10.1097\/AOG.0000000000001005","volume":"126","author":"RM Silver","year":"2015","unstructured":"Silver RM. Abnormal Placentation: Placenta Previa, Vasa Previa, and Placenta Accreta. Obstet Gynecol. 2015;126:654\u201368.","journal-title":"Obstet Gynecol"},{"key":"1472_CR2","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1080\/14767058.2017.1289163","volume":"31","author":"KJ Gibbins","year":"2018","unstructured":"Gibbins KJ, Einerson BD, Varner MW, Silver RM. Placenta previa and maternal hemorrhagic morbidity. J Matern Fetal Neonatal Med. 2018;31:494\u20139.","journal-title":"J Matern Fetal Neonatal Med"},{"key":"1472_CR3","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1111\/1471-0528.15306","volume":"126","author":"E Jauniaux","year":"2019","unstructured":"Jauniaux E, Alfirevic Z, Bhide AG, Belfort MA, Burton GJ, Collins SL, et al. Placenta Praevia and placenta Accreta: diagnosis and management: green-top guideline no. 27a. BJOG. 2019;126:e1\u2013e48.","journal-title":"BJOG."},{"key":"1472_CR4","doi-asserted-by":"publisher","first-page":"712","DOI":"10.1111\/tmi.12100","volume":"18","author":"JA Cresswell","year":"2013","unstructured":"Cresswell JA, Ronsmans C, Calvert C, Filippi V. Prevalence of placenta praevia by world region: a systematic review and meta-analysis. Tropical Med Int Health. 2013;18:712\u201324.","journal-title":"Tropical Med Int Health"},{"key":"1472_CR5","doi-asserted-by":"publisher","first-page":"e5107","DOI":"10.1097\/MD.0000000000005107","volume":"95","author":"D Fan","year":"2016","unstructured":"Fan D, Wu S, Wang W, Xin L, Tian G, Liu L, et al. Prevalence of placenta previa among deliveries in Mainland China: A PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore). 2016;95:e5107.","journal-title":"Medicine (Baltimore)"},{"key":"1472_CR6","doi-asserted-by":"crossref","unstructured":"Hawkins R, Evans M, Hammond S, Hartopp R, Evans E. Placenta accreta spectrum disorders - Peri-operative management: the role of the anaesthetist. Best Pract Res Clin Obstet Gynaecol. 2020.","DOI":"10.1016\/j.bpobgyn.2020.08.003"},{"key":"1472_CR7","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1097\/GCO.0000000000000575","volume":"31","author":"G Ratnayake","year":"2019","unstructured":"Ratnayake G, Patil V. General anaesthesia during caesarean sections: implications for the mother, foetus, anaesthetist and obstetrician. Curr Opin Obstet Gynecol. 2019;31:393\u2013402.","journal-title":"Curr Opin Obstet Gynecol"},{"key":"1472_CR8","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1093\/bja\/aes320","volume":"110","author":"AC Quinn","year":"2013","unstructured":"Quinn AC, Milne D, Columb M, Gorton H, Knight M. Failed tracheal intubation in obstetric anaesthesia: 2 yr national case-control study in the UK. Br J Anaesth. 2013;110:74\u201380.","journal-title":"Br J Anaesth"},{"key":"1472_CR9","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1016\/j.ijoa.2010.04.009","volume":"19","author":"CF Weiniger","year":"2010","unstructured":"Weiniger CF, Ivri S, Ioscovich A, Grimberg L, Evron S, Ginosar Y. Obstetric anesthesia units in Israel: a national questionnaire-based survey. Int J Obstet Anesth. 2010;19:410\u20136.","journal-title":"Int J Obstet Anesth"},{"key":"1472_CR10","doi-asserted-by":"crossref","unstructured":"Knigin D, Avidan A, Weiniger C. The effect of spinal hypotension and anesthesia-to-delivery time interval on neonatal outcomes in planned cesarean delivery. Am J Obstet Gynecol. 2020.","DOI":"10.1097\/01.aoa.0000766160.24091.89"},{"key":"1472_CR11","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1111\/anae.14080","volume":"73","author":"SM Kinsella","year":"2018","unstructured":"Kinsella SM, Carvalho B, Dyer RA, Fernando R, McDonnell N, Mercier FJ, et al. International consensus statement on the management of hypotension with vasopressors during caesarean section under spinal anaesthesia. Anaesthesia. 2018;73:71\u201392.","journal-title":"Anaesthesia."},{"key":"1472_CR12","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1056\/NEJMra021276","volume":"348","author":"HK Eltzschig","year":"2003","unstructured":"Eltzschig HK, Lieberman ES, Camann WR. Regional anesthesia and analgesia for labor and delivery. N Engl J Med. 2003;348:319\u201332.","journal-title":"N Engl J Med"},{"key":"1472_CR13","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1016\/S0959-289X(02)00183-8","volume":"12","author":"JY Hong","year":"2003","unstructured":"Hong JY, Jee YS, Yoon HJ, Kim SM. Comparison of general and epidural anesthesia in elective cesarean section for placenta previa totalis: maternal hemodynamics, blood loss and neonatal outcome. Int J Obstet Anesth. 2003;12:12\u20136.","journal-title":"Int J Obstet Anesth"},{"key":"1472_CR14","doi-asserted-by":"publisher","first-page":"3054","DOI":"10.1080\/14767058.2018.1457638","volume":"32","author":"D Fan","year":"2019","unstructured":"Fan D, Wu S, Ye S, Wang W, Wang L, Fu Y, et al. Random placenta margin incision for control hemorrhage during cesarean delivery complicated by complete placenta previa: a prospective cohort study. J Matern Fetal Neonatal Med. 2019;32:3054\u201361.","journal-title":"J Matern Fetal Neonatal Med"},{"key":"1472_CR15","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1186\/s12884-021-03923-1","volume":"21","author":"D Fan","year":"2021","unstructured":"Fan D, Zhang H, Rao J, Lin D, Wu S, Li P, et al. Maternal and neonatal outcomes in transverse and vertical skin incision for placenta Previa. BMC Pregnancy Childbirth. 2021;21:441.","journal-title":"BMC Pregnancy Childbirth"},{"key":"1472_CR16","doi-asserted-by":"publisher","first-page":"40320","DOI":"10.1038\/srep40320","volume":"7","author":"D Fan","year":"2017","unstructured":"Fan D, Wu S, Liu L, Xia Q, Wang W, Guo X, et al. Prevalence of antepartum hemorrhage in women with placenta previa: a systematic review and meta-analysis. Sci Rep. 2017;7:40320.","journal-title":"Sci Rep"},{"key":"1472_CR17","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1016\/j.ajog.2018.11.608","volume":"220","author":"RR Rimsza","year":"2019","unstructured":"Rimsza RR, Perez WM, Babbar S, O'Brien M, Vricella LK. Time from neuraxial anesthesia placement to delivery is inversely proportional to umbilical arterial cord pH at scheduled cesarean delivery. Am J Obstet Gynecol. 2019;220:389 e381\u2013389 e389.","journal-title":"Am J Obstet Gynecol"},{"key":"1472_CR18","doi-asserted-by":"publisher","first-page":"671","DOI":"10.2147\/IJWH.S310097","volume":"13","author":"J Rao","year":"2021","unstructured":"Rao J, Fan D, Zhou Z, Luo X, Ma H, Wan Y, et al. Maternal and neonatal outcomes of placenta Previa with and without coverage of a uterine scar: a retrospective cohort study in a tertiary hospital. Int J Women's Health. 2021;13:671\u201381.","journal-title":"Int J Women's Health"},{"issue":"Suppl 1","key":"1472_CR19","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1111\/aogs.14103","volume":"100","author":"A Schwickert","year":"2021","unstructured":"Schwickert A, van Beekhuizen HJ, Bertholdt C, Fox KA, Kayem G, Morel O, et al. Association of peripartum management and high maternal blood loss at cesarean delivery for placenta accreta spectrum (PAS): a multinational database study. Acta Obstet Gynecol Scand. 2021;100(Suppl 1):29\u201340.","journal-title":"Acta Obstet Gynecol Scand"},{"key":"1472_CR20","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1016\/j.placenta.2020.08.004","volume":"99","author":"LJ King","year":"2020","unstructured":"King LJ, Dhanya Mackeen A, Nordberg C, Paglia MJ. Maternal risk factors associated with persistent placenta previa. Placenta. 2020;99:189\u201392.","journal-title":"Placenta."},{"key":"1472_CR21","doi-asserted-by":"publisher","first-page":"1171","DOI":"10.1080\/14767058.2017.1311315","volume":"31","author":"S Orbach-Zinger","year":"2018","unstructured":"Orbach-Zinger S, Weiniger CF, Aviram A, Balla A, Fein S, Eidelman LA, et al. Anesthesia management of complete versus incomplete placenta previa: a retrospective cohort study. J Matern Fetal Neonatal Med. 2018;31:1171\u20136.","journal-title":"J Matern Fetal Neonatal Med"},{"key":"1472_CR22","doi-asserted-by":"publisher","first-page":"1432","DOI":"10.1016\/S0002-9378(99)70031-1","volume":"180","author":"MC Frederiksen","year":"1999","unstructured":"Frederiksen MC, Glassenberg R, Stika CS. Placenta previa: a 22-year analysis. Am J Obstet Gynecol. 1999;180:1432\u20137.","journal-title":"Am J Obstet Gynecol"},{"key":"1472_CR23","doi-asserted-by":"publisher","first-page":"725","DOI":"10.1093\/oxfordjournals.bja.a013582","volume":"84","author":"N Parekh","year":"2000","unstructured":"Parekh N, Husaini SW, Russell IF. Caesarean section for placenta praevia: a retrospective study of anaesthetic management. Br J Anaesth. 2000;84:725\u201330.","journal-title":"Br J Anaesth"},{"key":"1472_CR24","doi-asserted-by":"crossref","unstructured":"Bi S, Zhang L, Wang Z, Chen J, Tang J, Gong J, et al. Effect of types of placenta previa on maternal and neonatal outcomes: a 10-year retrospective cohort study. Arch Gynecol Obstet. 2021.","DOI":"10.21203\/rs.3.rs-17936\/v2"}],"container-title":["BMC Anesthesiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12871-021-01472-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12871-021-01472-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12871-021-01472-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,19]],"date-time":"2021-10-19T04:54:44Z","timestamp":1634619284000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-021-01472-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,19]]},"references-count":24,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["1472"],"URL":"https:\/\/doi.org\/10.1186\/s12871-021-01472-w","relation":{},"ISSN":["1471-2253"],"issn-type":[{"value":"1471-2253","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,19]]},"assertion":[{"value":"15 June 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 October 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 October 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Ethic Committee of the Affiliated Foshan Women and Children Hospital, Southern Medical University (FSFY-MEC-2019-044).This is retrospectively collected data study, and the datasets are fully anonymized prior to analysis. The need for consent was waived by the Academic Board of the Hospital.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"247"}}