| Second- and third-trimester therapeutic terminations of pregnancy in cases with complete placenta previa--does feticide decrease postdelivery maternal hemorrhage? | |
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MedLine Citation:
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PMID: 15539869 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To study the feasibility of second- and third-trimester termination of pregnancy (TOP) with complete placenta previa, and the impact of performing feticide before labor induction on maternal hemorrhagic morbidity. PATIENTS AND METHODS: From 1987 to 2002, the databases of two referral hospitals were reviewed. We identified 15 cases of second- or third-trimester TOP in women with complete placenta previa. Feticide was performed 2-14 days before induction in 6/15 cases. Cervical ripening was achieved in 8 cases by mifepristone alone (n = 2) or by mifepristone and dilapan (n = 6). Labor was induced by vaginal gemeprost (n = 2), intramuscular (n = 5) or intravenous (n = 4) sulprostone, vaginal misoprostol (n = 1) or a combination of misoprostol and sulprostone (n = 3). Hemorrhage was defined by the need for transfusion. The difference between the preoperative and the lowest per- or postoperative maternal hemoglobin level was also analyzed. RESULTS: Of the 9 women who underwent labor induction without previous feticide, 4 required blood transfusions, 1 of whom had a hemostat hysterectomy. The mean hemoglobin difference was 2.5 g/dl (range: 0.5-5.3). None of the 6 patients with preinduction feticide required transfusion. The hemoglobin difference was significantly smaller in this group than in terminations without previous feticide (mean: 1.0 g/dl ; range: 0.1-2.2; p = 0.03). CONCLUSION: In cases with complete placenta previa, second- or third-trimester TOP is feasible. It carries a substantial risk of hemorrhage that might be decreased by preinduction feticide. |
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Authors:
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R Ruano; Y Dumez; D Cabrol; M Dommergues |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Fetal diagnosis and therapy Volume: 19 ISSN: 1015-3837 ISO Abbreviation: Fetal. Diagn. Ther. Publication Date: 2004 Nov-Dec |
Date Detail:
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Created Date: 2004-11-12 Completed Date: 2005-02-10 Revised Date: 2005-11-17 |
Medline Journal Info:
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Nlm Unique ID: 9107463 Medline TA: Fetal Diagn Ther Country: Switzerland |
Other Details:
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Languages: eng Pagination: 475-8 Citation Subset: IM |
Copyright Information:
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2004 S. Karger AG, Basel. |
Affiliation:
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Maternité, Hôpital Necker Enfants Malades, AP-HP et Université Paris V, Paris, France. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Abortion, Therapeutic
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methods* Blood Transfusion Female Hemoglobins Humans Labor, Obstetric Placenta Previa / mortality, therapy* Postpartum Hemorrhage / mortality, prevention & control* Pregnancy Pregnancy Trimester, Second Pregnancy Trimester, Third Risk Factors |
| Chemical | |
Reg. No./Substance:
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0/Hemoglobins |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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