Abnormal Invasive Placentation Simulation of Emergency Scenario: Low- and Full-Resource Setting

Simulation scenarios are an excellent option to promote linear and lateral thinking to solve problems, especially in life-threatening situations. Emergencies in the placenta accreta spectrum (PAS) need clear and immediate decisions; placenta accreta has particular problems that make it challenging to perform hemostasis. In low settings, the main objective is to avoid massive bleeding using simple and effective measures. The surgical plan is defined in full-resource settings after a detailed analysis of image findings. The simulation allows discussion of anatomy, strong adhesion from uncommon tissues, and hemodynamic and hemostatic parameters. Unfortunately, information, management, or decisions are lost in time; thus, working with simulation scenarios is recommendable periodically. Technical skills need training and surgical practice under supervision to improve results. Simulation is a place to think, make a mistake, and open the mind to solve problems in different scenarios. The learning may include interactive discussion, analyze faults, and appreciate their consequences without causing harm to patients. The management of crisis events can be practiced and rehearsed to enable personnel to be better prepared when such events occur in real life.