Intra-operative cardiac arrest from undiagnosed incretic placenta praevia precipitated haemorrhage reversed via external jugular access: a case report

Abstract

A 32-year old obese multipara with undiagnosed incretic major degree placenta praevia was scheduled to have an elective repeat Caesarean for two previous caesarean. Under subarachnoid anaesthesia, placental severance and myometrial avulsion precipitated torrential haemorrhage occasioning intraoperative cardiac arrest which necessitated external jugular access for successful resuscitation. Following peripartum hysterectomy under general anaesthesia, she received intensive care and was discharged to the ward after 48 hours. This report highlights the necessity of accurate prenatal diagnosis of invasive placentation and the grave sequelae of a missed diagnosis, as well as the strategic significance of external jugular access in resuscitation post-cardiac arrest from massive haemorrhage.