Re: Question about placenta accreta

From: Andrew Folley (agfolley@hotmail.com)
Sat Oct 28 11:39:12 2006


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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