Advantages of neuraxial anesthesia for cesarean delivery

We read with great interest the article “Perinatal outcomes comparison between neuraxial and general anesthesia in pregnant women with placenta accreta spectrum: a multicenter retrospective study by Chenmian Liu and colleagues [1]. This retrospective study is notably because it investigates the impact of anesthesia techniques for cesarean delivery in patients with placenta accreta spectrum (PAS). Placenta accreta is a pathologic condition of placentation associated with a high-risk during delivery of massive obstetric haemorrhage that is among the leading causes of severe maternal outcomes [2]. The Authors investigated the influence of neuraxial (NA) or general (GA) anesthesia on perinatal outcomes in women with PAS undergoing cesarean delivery and collected data from 425 patients treated with either NA or GA. To optimize group matching, the Authors eliminated several confounding factors ultimately selecting 2 groups of 81 comparable patients and concluded that patients treated with NA had a significantly: lower periprocedural bleeding, less need for packed red blood cells (PRBC) This comment refers to the article available online at https://doi.org/ 10.1007/s00540-023-03287-0. * Anna Maria Biava [email protected] Gianni Cipriani [email protected] Endrit Malja [email protected] Federico Bilotta [email protected] 1 2 Department of Anesthesiology, Fatebenefratelli Villa San Pietro Hospital, Rome, Italy Department of Anesthesiology and Critical Care, Sapienza University of Rome, Rome, Italy transfusion, shorter operation time and postoperative length of stay (p < 0.05). No difference was recorded on neonatal outcomes.