Journal of Capital Medical University ›› 2013, Vol. 34 ›› Issue (4): 623-628.doi: 10.3969/j.issn.1006-7795.2013.04.029

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Diagnosis and management of placenta accreta in induced abortion of the second trimester

LUO Lanrong, LI Jian   

  1. Department of Family Planning, Beijing Obstetrics and Gynecology Hospital, Beijing 100026, China
  • Received:2013-04-19 Online:2013-08-21 Published:2013-07-20

Abstract:

Placenta accreta is a severe complication of pregnancy that is significant contributor to postpartum hemorrhage and maternal morbidity. It becomes currently the most common indication for peripartum hysterectomy due to massive hemorrhage. Even in the artificial abortion of the second trimester, we face the risk of placenta accreta as well. In this article, we review the epidemiology, etiology, diagnosis and management of placenta accreta, especially the high risk factors and diagnosis. The managements include operations and medications. Operation treatments include B-mode ultrasound guided dilatation and curettage, local resection by laparotomy or hysteroscopy, hysterectomy and transcatheter artery embolization. Medications include methotrexate, mifepristone, 5-fluorouracil(5-Fu), ethacridine, Chinese traditional medicine and so on. On account of the fertility desire of women who need induced abortion in the second trimester, the diagnosis of the placenta accreta should be made as soon as possible according to the screening for predisposing factors and careful examination both in prenatal phase and abortion. Conservative management should be considered first with caution to preserve fertility as far as possible.

Key words: placenta accreta, diagnosis, management

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