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Related Experiment Videos

Second- and third-trimester therapeutic terminations of pregnancy in cases with complete placenta previa--does

R Ruano1, Y Dumez, D Cabrol

  • 1Maternité, Hôpital Necker Enfants Malades, AP-HP et Université Paris V, Paris, France.

Fetal Diagnosis and Therapy
|November 13, 2004
PubMed
Summary

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Second- or third-trimester termination of pregnancy (TOP) with placenta previa is feasible but carries hemorrhage risks. Preinduction feticide significantly reduced the need for blood transfusions in these cases.

Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Reproductive Health

Background:

  • Complete placenta previa presents significant challenges for second- and third-trimester pregnancy termination.
  • Hemorrhagic complications are a major concern during termination procedures in the presence of placenta previa.

Purpose of the Study:

  • To evaluate the feasibility of second- and third-trimester termination of pregnancy (TOP) in women with complete placenta previa.
  • To assess the impact of preinduction feticide on maternal hemorrhagic morbidity during TOP for complete placenta previa.

Main Methods:

  • A retrospective review of 15 cases of second- or third-trimester TOP with complete placenta previa between 1987 and 2002.
  • Feticide was performed prior to labor induction in 6 cases; labor was induced using various agents including mifepristone, dilapan, gemeprost, sulprostone, and misoprostol.

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  • Hemorrhage was defined by transfusion requirement, and hemoglobin levels were analyzed pre- and post-procedure.

    • Main Results:

    • Four out of nine women (44%) undergoing TOP without feticide required blood transfusions, with one needing a hysterectomy.
    • In contrast, none of the six patients who underwent preinduction feticide required blood transfusions.
    • The mean hemoglobin difference was significantly lower in the feticide group (1.0 g/dL) compared to the non-feticide group (2.5 g/dL; p = 0.03).

    Conclusions:

    • Second- and third-trimester termination of pregnancy is feasible in cases of complete placenta previa.
    • Preinduction feticide appears to be an effective strategy for reducing maternal hemorrhagic morbidity in these procedures.