Scheduled hysterectomy for second-trimester abortion in a patient with placenta accreta.

Abstract

As cesarean deliveries increase, so does placenta accreta. There is little evidence regarding management of patients with known or suspected abnormal placentation seeking abortion. A medically complicated patient with evidence of placenta increta on magnetic resonance imaging presented for pregnancy termination at 15 weeks of gestation. Scheduled hysterectomy was performed to avoid hemorrhage and subsequent complications. The patient did well postoperatively; her course was complicated only by a wound infection treated as an outpatient. Pathology was consistent with placenta increta. Placenta accreta has increased 13-fold in the past 30 years. In select patients with evidence of abnormal placentation, scheduled hysterectomy for termination of pregnancy is an option that may be considered.