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- Title
Placenta praevia and the risk of adverse outcomes during second trimester abortion: A retrospective cohort study.
- Authors
Perriera, Lisa K.; Arslan, Alan A.; Masch, Rachel
- Abstract
Background There are few reports in the literature of the risks associated with second trimester abortion in women with placenta praevia ( PP). We hypothesise that PP increases the risk of complications. Aims We sought to determine if PP is associated with a higher risk of blood loss and blood transfusion at the time of dilation and evacuation (D&E). Materials and methods The records of 612 consecutive women undergoing abortion at 15-24 weeks of gestation were reviewed. Participant characteristics, need for blood transfusion, estimated blood loss ( EBL) during the abortion and other complications were compared between women with and without ultrasound-documented PP. Results Eighty-seven of 612 (14.2%, 95% CI 11.5-17.2%) women had ultrasound-documented PP. The rate of blood transfusion was 3.4 and 1.3% in the group with PP and without PP, respectively (adjusted relative risk ( RR = 2.8, 95% CI 0.7-11.3). An estimated blood loss of 500 cc or greater during the D&E procedure was observed in 12.6% of women in the PP group compared with 4.2% of women in the group without PP (adjusted RR 3.1, 95% CI 1.4-6.8, P = 0.004). Conclusions Second-trimester abortion in women with PP is associated with a higher risk of blood loss of 500 cc or greater. Our study represents a larger sample size of patients with PP undergoing second-trimester abortion than previously reported in the literature. Women with PP may have a higher estimated blood loss and may require access to blood transfusion.
- Subjects
ABORTION; ANALYSIS of variance; BLOOD transfusion; CHI-squared test; CONFIDENCE intervals; HYSTERECTOMY; LONGITUDINAL method; MULTIVARIATE analysis; PLACENTA praevia; SECOND trimester of pregnancy; T-test (Statistics); SAMPLE size (Statistics); STATISTICAL power analysis; RELATIVE medical risk; RETROSPECTIVE studies; DATA analysis software; DILATATION &; curettage; SURGICAL blood loss; DISEASE complications
- Publication
Australian & New Zealand Journal of Obstetrics & Gynaecology, 2017, Vol 57, Issue 1, p99
- ISSN
0004-8666
- Publication type
Article
- DOI
10.1111/ajo.12580