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Re: Developing AccretaFrom: James S Smeltzer MD (gaperina@mindspring.com)Mon Aug 24 06:47:09 1998
At 02:44 PM 8/22/1998 -0500, you wrote: > Did not come thru but q was detectability of percreta. Hi Martin, In my 15 years of prenatal diagnosis I have been singularly unimpressed with my and my peers' ability to perform this simple task. A patient scanned at a leading sonography center came into our ER DOA because of a percreta which was not detected or detectable by a 16 week scan done there. I have thought I had percreta on multiple occasions to find that I did not. Others have been through the same thing. I had an increta which was extensive that was manifested by a second stage arrest in a 20 week miscarriage, and by numerous flame-like lakes in the placenta (Base to surface & ramified). I did not recognize that as a manifestation at the time. This patient died of this cause after delivery. I have subsequently seen this four times & three had accreta, two lost uterus, two preterm & one normal outcome. This is humbling, as I approach every problem of pregnancy as diagnosable by US until proven otherwise. Why do you ask? Jim Smeltzer MD (perinatal@perinatal.net)
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