Placenta Accreta Spectrum Disorders: Knowledge Gaps in Anesthesia Care.

Area of Science:

• Obstetrics and Gynecology
• Anesthesiology
• Maternal-Fetal Medicine

Background:

• Placenta accreta spectrum (PAS) is a high-risk pregnancy complication associated with significant morbidity.
• Optimal management necessitates multidisciplinary expertise, with obstetric anesthesiologists playing a crucial role.
• Current knowledge gaps exist regarding anesthesia care for PAS patients.

Purpose of the Study:

• To highlight critical knowledge gaps in the anesthesia management of placenta accreta spectrum disorder.
• To identify areas requiring further research to optimize peripartum care for these patients.

Main Methods:

• This study is a review of current literature and clinical practice regarding anesthesia for PAS.
• Identifies specific areas lacking evidence, including staffing, delivery location, anesthesia techniques, and hemorrhage management.

Main Results:

• Limited data exist on optimal anesthesia staffing, delivery location, and primary anesthesia mode for cesarean delivery in PAS.
• Evidence is lacking on preoperative blood ordering, use of antifibrinolytics and hemostatic agents, and postoperative pain management strategies.
• The impact of anesthesia decisions on patient outcomes remains unclear.

Conclusions:

• Significant knowledge gaps impede optimal anesthesia care for patients with PAS.
• High-quality international multicenter studies are essential to address these gaps and advance patient care.
• Further research is needed to establish evidence-based guidelines for anesthesia management in PAS.