Anesthesia for the repeat cesarean section in the parturient with abnormal placentation: what does an obstetrician need to know?

Placenta accreta is an abnormal adherence of the placenta to the uterine wall owing to an absent or faulty decidua basalis. The incidence of this devastating problem is increasing secondary to the increased incidence of Cesarean section. Although rare, the diagnosis of placenta accreta may lead to life-threatening complications (e.g., fatal hemorrhage) and significantly impact the obstetric and anesthetic management of these parturients. I herein present the case of a pregnant patient with abnormal placentation and review the current state-of-the-art obstetric and anesthetic management of this complication.