Coronary Venous Air Embolism in Placenta Accreta Spectrum Cesarean Hysterectomy

Placenta accreta spectrum (PAS) is a disorder of placental-uterine attachment often linked to placenta previa and prior cesarean delivery and characterized by hemorrhage with placental separation. Standard treatment for PAS in the United States is cesarean hysterectomy. Venous air embolism is a cesarean delivery complication defined as air trapped in the venous system.

We report a coronary artery venous air embolism during a cesarean hysterectomy managed with a surgical intermission, with mortality risk assessment and temporary conservative management as a bridge to hemodynamic stability.

Venous air embolism must be promptly recognized and treated. Acute cardiac events (eg, venous air embolism) in complex obstetric surgery require a methodical approach and interdisciplinary expertise. Given the increasing incidence of PAS and complex obstetric surgery, it is crucial for physicians to be aware of management strategies.