Spinal Versus General Anesthesia in Pregnancies With Placenta Accreta Spectrum: A Retrospective Comparative Study

NCT07406841 | Not Yet Recruiting

• 1 other identifier: GZŞH-ANES-PAS-2025
• Study Type: observational
• Target: 50
• Locations: 0 countries
• Sites: N/A

Brief Summary

Placenta accreta spectrum (PAS) is a serious pregnancy complication in which the placenta grows abnormally into the uterine wall. This condition is associated with a high risk of severe bleeding, need for blood transfusion, hysterectomy, and maternal complications during cesarean delivery. This study aims to compare spinal anesthesia and general anesthesia in pregnant women diagnosed with placenta accreta spectrum who underwent cesarean delivery. The researchers reviewed existing medical records to evaluate differences in maternal and neonatal outcomes between the two anesthesia approaches. The primary outcomes include changes in hemoglobin levels before and after surgery, the need for uterotonic medications during and after the operation, and newborn Apgar scores. Because this is a retrospective observational study, no new treatments were given, and all data were collected from routine clinical care records. The findings are expected to help guide anesthetic decision-making in PAS cases, improve maternal and neonatal safety, and contribute to the international scientific literature on this topic.

Conditions

Placenta Accreta Spectrum

Keywords

Placenta accreta spectrum; PAS; spinal anesthesia; general anesthesia

Outcome Measures

Primary Outcomes (3)

• Length of Hospital Stay to Discharge

  Total duration of maternal hospitalization calculated from the time of cesarean delivery until official hospital discharge.

  Postoperative day of hospital discharge, assessed up to 30 days after cesarean delivery.

• Perioperative Hemoglobin Change

  The difference between preoperative hemoglobin level and postoperative hemoglobin level measured within the first 48 hours after cesarean delivery in patients with placenta accreta spectrum.

  From preoperative assessment to 48 hours after cesarean delivery

• Neonatal Apgar Score at 1 and 5 Minutes

  Neonatal Apgar scores assessed at 1 and 5 minutes after birth in infants delivered by cesarean section in pregnancies with placenta accreta spectrum.

  At 1 minute and 5 minutes after birth

Study Arms (2)

Spinal Anesthesia

This cohort includes pregnant patients diagnosed with placenta accreta spectrum who underwent cesarean delivery under spinal anesthesia as part of routine clinical care. The anesthetic technique was selected by the multidisciplinary clinical team based on standard institutional practice and individual patient characteristics. No experimental intervention was applied for research purposes.

Procedure: spinal anesthesia

General Anesthesia

This cohort includes pregnant patients diagnosed with placenta accreta spectrum who underwent cesarean delivery under general anesthesia as part of routine clinical care. The anesthetic technique was selected by the multidisciplinary clinical team based on standard institutional practice and individual patient characteristics. No experimental intervention was applied for research purposes.

Procedure: General Anesthesia

Interventions

spinal anesthesia PROCEDURE

Spinal anesthesia administered for cesarean delivery as part of routine clinical care in pregnant patients with placenta accreta spectrum. The technique was chosen by the clinical team based on standard institutional practice and patient condition, not for research assignment.

Spinal Anesthesia

General Anesthesia PROCEDURE

General anesthesia was administered for cesarean delivery in pregnant patients with placenta accreta spectrum as part of routine clinical care. The anesthetic technique, including airway management, induction agents, and maintenance strategy, was selected by the attending anesthesia team according to institutional standards and the patient's clinical condition. The intervention was not assigned for research purposes.

General Anesthesia

Eligibility Criteria

• Age: 18 Years - 45 Years
• Sex: female
• Healthy Volunteers: No
• Age Groups: Adult (18-64)
• Sampling Method: Non-Probability Sample

Study Population

The study population consists of pregnant women diagnosed with placenta accreta spectrum (PAS) who underwent elective cesarean delivery at Gaziantep City Hospital. Participants were identified retrospectively from hospital medical records and anesthesia charts. Only patients with singleton pregnancies and complete perioperative and neonatal data were included in the analysis. The population reflects routine clinical practice in the management of PAS at a tertiary care center.

You may qualify if:

• Pregnant patients diagnosed with placenta accreta spectrum (PAS), Undergoing elective cesarean delivery, Receiving either spinal anesthesia or general anesthesia during cesarean section, Singleton pregnancy, Availability of complete medical and anesthesia records related to surgery and perioperative management

You may not qualify if:

• Patients without a diagnosis of PAS, Emergency (non-elective) cesarean deliveries, Use of anesthesia techniques other than spinal or general anesthesia, Multiple pregnancy (twins or more) ,Incomplete or missing medical/anesthesia records, Missing key perioperative or neonatal outcome data

Sponsors & Collaborators

• Gaziantep City Hospital: lead

MeSH Terms

Conditions

Placenta Accreta

Interventions

Anesthesia, Spinal; Anesthesia, General

Condition Hierarchy (Ancestors)

Obstetric Labor Complications; Pregnancy Complications; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Placenta Diseases

Intervention Hierarchy (Ancestors)

Anesthesia, Conduction; Anesthesia; Anesthesia and Analgesia

Central Study Contacts

Recep Karakaşoğlu, MD

CONTACT

+905364668718; erecep_1992@hotmail.com

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: February 3, 2026
• First Posted: February 12, 2026
• Study Start: February 1, 2026
• Primary Completion: February 1, 2026
• Study Completion: March 30, 2026
• Last Updated: February 12, 2026

Record last verified: 2026-02