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Placenta accreta spectrum (PAS) is a complex obstetric condition with a rising incidence in parallel with the rising rate of cesarean delivery. Given the significant and rapid hemorrhage associated with cesarean hysterectomy it is critically important to prepare for resuscitation and transfusion. Both neuraxial and general anesthesia can be used, each having their own advantages and disadvantages. The diagnosis of PAS can have significant mental health effects on the mother that need to be considered both during pregnancy and postpartum.