Critical Care in Placenta Accreta Spectrum Disorders-A Call to Action.

Area of Science:

• Obstetrics and Gynecology
• Critical Care Medicine
• Anesthesiology

Background:

• The incidence of placenta accreta spectrum (PAS) is rising globally.
• PAS poses significant risks including massive hemorrhage, hemodynamic instability, and end-organ damage.
• Current management requires specialized critical care resources and expertise.

Purpose of the Study:

• To highlight the critical need for intensive care unit (ICU) resources for patients with PAS.
• To emphasize the importance of multidisciplinary collaboration and specialized tertiary care for PAS management.
• To discuss the utility of emerging tools in optimizing care for PAS patients.

Main Methods:

• Review of current literature and clinical guidelines for PAS management.
• Discussion of the role of intensive care units (ICUs) with surgical expertise.
• Evaluation of validated tools like point-of-care ultrasound and thromboelastometry (TEG/ROTEM) for hemodynamic and hematological assessment.

Main Results:

• Patients with PAS require critical care expertise due to high risk of hemorrhage and shock.
• Point-of-care ultrasound and TEG/ROTEM aid in real-time hemodynamic and transfusion management.
• Multidisciplinary collaboration and management in experienced tertiary centers are crucial for optimal outcomes.

Conclusions:

• Placenta accreta spectrum necessitates critical care expertise and specialized management.
• Advanced monitoring and transfusion strategies are vital for managing PAS-related complications.
• Referral to tertiary centers with surgical ICU capabilities is recommended for high-risk PAS patients.