In this episode of the FlightBridgeED Podcast, Dr. Michael Lauria and guest Dr. Alex Pfeiffer, a maternal-fetal medicine (MFM) fellow, delve into the critical and complex topic of Placenta Accreta Spectrum Disorder (PAS). With its rapidly evolving complications, this condition demands acute recognition, careful transport coordination, and multidisciplinary care. Together, they unpack the spectrum’s pathophysiology, risk factors, diagnostic strategies, and advanced management protocols essential for critical care and transport teams. Whether you’re a seasoned provider or new to pre-hospital medicine, this episode provides practical knowledge and actionable insights to elevate your clinical practice.

Catch this episode and more wherever you listen to podcasts or on our website at flightbridgeed.com. While there, explore our award-winning courses and other free content in our Culture section to advance your career and expand your critical care expertise.

Takeaways

Advanced Insight: The importance of understanding PAS as a spectrum, including the implications of invasive placentation on maternal hemorrhage and the role of multidisciplinary teams in patient outcomes.
Practical Application: Early recognition of PAS through clinical and diagnostic signs, such as Doppler flow abnormalities, hypervascularity, and placental lakes, to facilitate timely and appropriate interventions.
Foundational Knowledge: Awareness of risk factors like prior cesarean sections, placenta previa, and uterine surgeries that increase the likelihood of PAS and necessitate careful monitoring.

References
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14. Shamshirsaz AA, Fox KA, Erfani H, et al. Coagulopathy in surgical management of placenta accreta spectrum. Eur J Obstet Gynecol Reprod Biol. Jun 2019;237:126-130. doi:10.1016/j.ejogrb.2019.04.026

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16. Simonazzi G, Bisulli M, Saccone G, Moro E, Marshall A, Berghella V. Tranexamic acid for preventing postpartum blood loss after cesarean delivery: a systematic review and meta-analysis of randomized controlled trials. Acta Obstet Gynecol Scand. Jan 2016;95(1):28-37. doi:10.1111/aogs.12798

17. Tadayon M, Javadifar N, Dastoorpoor M, Shahbazian N. Frequency, Risk Factors, and Pregnancy Outcomes in Cases with Placenta Accreta Spectrum Disorder: A Case-Control Study. J Reprod Infertil. Oct-Dec 2022;23(4):279-287. doi:10.18502/jri.v23i4.10814

18. Tinari S, Buca D, Cali G, et al. Risk factors, histopathology and diagnostic accuracy in posterior placenta accreta spectrum disorders: systematic review and meta-analysis. Ultrasound Obstet Gynecol. Jun 2021;57(6):903-909. doi:10.1002/uog.22183

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