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Re: Placenta AccretaFrom: ainsron (ainsron@sbcglobal.net)Fri Feb 15 11:26:50 2008
Be prepared for C-Hysterectomy - consent, blood available (lots). MRI could be useful for diagnosis, but at this point it sounds like it is highly likely, so what difference would an MRI make? Either way you're going to need to be prepared for C-hysterectomy. If it doesn't separate easily I would go quickly to hysterectomy. If she wanted conservative options, I would refer to tertiary care center and let them roll the dice if they feel lucky. For my part, I would do everything I can safely do to protect the patient, not the uterus. Ronald E. Ainsworth, MD, FACOG -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Andrew Folley Sent: Friday, February 15, 2008 9:53 AM To: Multiple recipients of list OB-GYN-L Subject: Re: Placenta Accreta G3P2 now at 27 weeks with know complete previa since 12 weeks. Admit to hospital wednesday for steroids in light of short cervix or 9mm and +Ffn. Echo in hospital confirms previa and also suggests placenta accreta on "right lateral side". Patient would like more children. Any thoughts on management?? ie plan for c-hyst? Use interventional radiology? Do c-section and leave placenta and treat with methotrexate? Do section and do the best I can in extracting placenta and be prepared....???? thanks agf PS Benefits tif any for Cat scan or MRI to diagnose percreta or increta??
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