Placenta accreta encountered during dilation and evacuation in the second trimester.
OBJECTIVE
To assess the frequency of placenta accreta encountered during dilation and evacuation (D&E) in the second trimester.


METHODS
Among 16,827 second-trimester D&E procedures performed at our hospitals and clinics, seven cases of placenta accreta, either suspected clinically or proven histologically, were encountered. These cases were analyzed for history of prior cesarean delivery, placenta localization, and histology of hysterectomy specimens.


RESULTS
Six of the seven cases suspected clinically were confirmed histologically. All placenta accreta patients had at least one cesarean delivery (mean 1.7), and five had a preoperative sonogram demonstrating some form of placenta previa. The prevalence of clinical placenta accreta encountered during D&Es in the second trimester was 0.04%, the same as that reported for placenta accreta diagnosed clinically in the third trimester.


CONCLUSIONS
Placenta accreta can be a potential complicating factor in the patient undergoing D&E in the second trimester.
Rashbaum
W K
WK
Department of Obstetrics and Gynecology, Albert Einstein College of Medicine, Bronx, New York, USA.
Gates
E J
EJ
Jones
J
J
Goldman
B
B
Morris
A
A
Lyman
W D
WD
D000028:Abortion, Induced; D000328:Adult; D002585:Cesarean Section; D004107:Dilatation and Curettage; D005260:Female; D006801:Humans; D010921:Placenta Accreta / Q000453:epidemiology* / Q000473:pathology; D010923:Placenta Previa / Q000453:epidemiology; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D015995:Prevalence