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Placenta accreta encountered during dilation and evacuation in the second trimester
W K Rashbaum1, E J Gates, J Jones
1Department of Obstetrics and Gynecology, Albert Einstein College of Medicine, Bronx, New York, USA.
Obstetrics and Gynecology
|May 1, 1995
Summary
Second-trimester Dilation and Evacuation (D&E) procedures can encounter placenta accreta, a serious complication. The study found placenta accreta in 0.04% of cases, highlighting risks for women with prior cesarean deliveries.
Area of Science:
- Reproductive Medicine
- Gynecologic Surgery
Background:
- Placenta accreta is a significant obstetric complication.
- Second-trimester Dilation and Evacuation (D&E) is a common procedure.
Purpose of the Study:
- To determine the incidence of placenta accreta during second-trimester D&E.
- To identify risk factors associated with placenta accreta in this context.
Main Methods:
- Retrospective analysis of 16,827 second-trimester D&E procedures.
- Inclusion of cases with clinically suspected or histologically confirmed placenta accreta.
- Review of patient history, sonographic findings, and hysterectomy specimens.
Main Results:
- Seven cases of placenta accreta were identified, yielding a prevalence of 0.04%.
- All affected patients had a history of at least one Cesarean delivery (mean 1.7).
- Five patients had preoperative sonograms showing placenta previa.
Conclusions:
- Placenta accreta is a potential complication during second-trimester D&E.
- Prior Cesarean delivery and placenta previa are associated risk factors.
- The incidence of placenta accreta during second-trimester D&E is similar to third-trimester diagnoses.