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Placenta Accreta Pre-Op Planning — FRCA Final MCQ

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HardObstetric AnaesthesiaPlacenta Accreta Pre-Op PlanningFRCA Final

A 50-year-old woman at 30 weeks gestation with known placenta accreta spectrum is scheduled for an elective caesarean hysterectomy at 36 weeks. What is the single most important pre-operative preparation?

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Correct answer: E — Start IV oxytocin infusion pre-operatively

Placenta accreta spectrum (PAS) disorders carry a very high risk of life-threatening haemorrhage (average blood loss 3-5 L). The single most important preparation is multidisciplinary planning: this includes involvement of experienced obstetric surgeon, anaesthetist (consultant), interventional radiologist (for uterine artery balloon occlusion/embolisation), neonatologist, haematologist, cell salvage team, and blood bank. Massive haemorrhage protocol should be pre-activated with at least 6 units crossmatched, FFP, cryoprecipitate, and platelets available. The procedure should take place in a centre with appropriate expertise.

Reference: RCOG – 2018 – Placenta accreta diagnosis and management; OAA – 2024 – QRH: Massive obstetric haemorrhage