Placenta accreta spectrum in the second trimester: a clinical conundrum in procedural abortion care - 24/12/24
Abstract |
Given the limitations in perioperative management strategies available at freestanding abortion clinics, abortion providers must commonly discern which patients are too complicated for procedural abortions at their center and must be referred for a hospital-based abortion. The need to transition from freestanding clinics to hospital-based abortion care can lead to delays in completing an abortion and significant social, economic, and psychological repercussions for the pregnant individual. One significant clinical problem that exemplifies the issue of who can be safely taken care of at a freestanding abortion clinic is when the placenta accreta spectrum is suspected. Placenta accreta spectrum is one of the major contributors to maternal morbidity and mortality in the United States, requiring coordinated multidisciplinary management to ensure the safest outcome for the pregnant individual. In this Clinical Opinion, we review the literature focused on identifying individuals at risk for placenta accreta spectrum >14+0 weeks gestation, delineate an algorithm to improve the frequency of timely referrals to hospital-based abortion providers, and propose next steps for future training goals and research on placenta accreta spectrum in the second trimester between complex family planning and maternal-fetal medicine subspecialists.
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Key words : abortion, complex family planning, maternal fetal medicine, obstetrics, placenta accreta, placenta accreta index, ultrasound
Plan
A.P is on the scientific advisory board for GenBioPro. B.D.E. was supported by Eunice Kennedy Shriver National Institute of Child Health and Human Development (K23HD106009) during the completion of this work. G.M. is a clinical faculty trainer for the Nexplanon device with Organon and has previously been on a scientific advisory board for Medicines360. |
Vol 232 - N° 1
P. 92-101 - janvier 2025 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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