PLACENTA-ACCRETA ENCOUNTERED DURING DILATION AND EVACUATION IN THE 2ND TRIMESTER

Objective: To assess the frequency of placenta accreta encountered dur ing dilation and evacuation (D&E) in the second trimester. Methods: Am ong 16,827 second-trimester D&E procedures performed at our hospitals and clinics, seven cases of placenta accreta, either suspected clinica lly or proven histologically, were encountered. These cases were analy zed 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 accre ta patients had at least one cesarean delivery (mean 1.7), and five ha d 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 placent a accreta diagnosed clinically in the third trimester. Conclusion: Pla centa accreta can be a potential complicating factor in the patient un dergoing D&E in the second trimester.