A 34-year-old G3P2 at 36 weeks with complete placenta previa and two previous cesarean sections undergoes elective cesarean. Intraoperatively, the placenta is found adherent and cannot be separated. The surgeon decides to leave the placenta in situ and perform a hysterectomy. What is the most important preoperative preparation for this scenario?

• A Prophylactic antibiotics
• B Cross-matching 4 to 6 units of packed red cells
• C Availability of cell saver
• D Informed consent for hysterectomy ✓

Explanation

In suspected placenta accreta spectrum with previa, informed consent must explicitly include the possibility of hysterectomy, as it is the definitive treatment. While blood products and antibiotics are essential, consent for hysterectomy is the most critical preoperative step.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.