Re: Question about placenta accreta

From: Meenan, Anna (annam@uic.edu)
Sat Oct 28 18:06:52 2006


But would anything have altered the outcome in THIS particular case? It's quite possible that the OB was thinking accreta and was perhaps prepared. We are not privy to his/her thought processes. In this case, I'm wondering if anyone could have done anything to improve the outcome that was achieved. (i.e. is someone alleging that knowing for sure it was an accreta would have saved her uterus?

Anna Meenan, MD

>Much of OB-gyn and medicine in general is based
>on the art of "anticipation of problems".
>Anticipating accreta,percreta and increta in a
>woman with 4th c-section and previa should be a
>given. Particularly as we are going to see more
>and more of this as our c-section rate climbs.
>Anticipation leads to the 5 P-s (preparation
>prevents p!$$ poor performance). Several things
>may be done in advance in this situation to
>prevent a bad outcome.
>
>>From: "Meenan, Anna" <annam@uic.edu>
>>Reply-To: ob-gyn-l@obgyn.net
>>To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
>>Subject: Re: Question about placenta accreta
>>Date: Sat, 28 Oct 2006 11:19:09 -0500
>>
>>Just curious as to whether someone is thinking
>>that knowing in advance would have altered the
>>outcome.
>>
>>Anna Meenan, MD
>>
>>>We had a patient today who had a scheduled
>>>repeat c/section (had 3 previous sections) for
>>>a long known complete previa. Her due date was
>>>I think 5 days away.
>>>
>>>When it was time to get the placenta out, doc
>>>noticed the accreta, she hemorrhaged needing 2
>>>units of packed cells and an emergency
>>>hysterectomy. Doing fine in the ICU overnight.
>>>
>>>Am curious to know if the accreta could have
>>>been noticed previously on several ultrasounds
>>>she had over the last 3 months.
>>>
>>>Gail Neuman RNC CPHW SNP
>>>Director of Perinatal Services
>>>Montclair Hospital Medical Center
>>>student nurse practitioner and student midwife
>>>Perinatal education
>>>OB Legal Nurse Consultant
>>>Perinatal Nurse Associates
>>>Santa Ana, CA
>





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