Document Detail

Is endomyometrial injury during termination of pregnancy or curettage following miscarriage the precursor to placenta accreta?
MedLine Citation:
PMID:  15735159     Owner:  NLM     Status:  MEDLINE    
AIMS: To determine the frequency with which myometrium is removed during vacuum terminations of pregnancy or dilatation and curettage after miscarriage, and to relate these findings to subsequent placenta accreta or its proxies. METHODS: Archival tissues from vacuum termination of pregnancy or dilatation and blunt curettage after miscarriage were examined for the presence of myometrium. The subsequent obstetric histories were scrutinised for manual removal of placenta, postpartum haemorrhage, or retained placenta. A retrospective study comparing the frequency of miscarriage and termination in women who had or did not have a manual removal was also performed. RESULTS: Myometrium was seen in the products of conception in 44% and 35% of termination and miscarriage tissues, respectively. One of nine women with myometrium at miscarriage had a postpartum haemorrhage in a subsequent pregnancy whereas, of the 21 women without myometrium at miscarriage, three required manual removal and seven had a postpartum haemorrhage afterwards. A past history of termination and/or miscarriage was more frequent in multigravid women who had a manual removal than those who did not. CONCLUSIONS: Endomyometrial injury is frequent at termination or dilatation and curettage after miscarriage, but the relation to subsequent placenta accreta remains unclear. Women requiring a manual removal of the placenta were likely to have had a past history of termination and/or miscarriage.
J M Beuker; J J H M Erwich; T Y Khong
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of clinical pathology     Volume:  58     ISSN:  0021-9746     ISO Abbreviation:  J. Clin. Pathol.     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-02-28     Completed Date:  2005-03-29     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0376601     Medline TA:  J Clin Pathol     Country:  England    
Other Details:
Languages:  eng     Pagination:  273-5     Citation Subset:  AIM; IM    
Department of Histopathology, Women's and Children's Hospital, North Adelaide SA 5006, Australia.
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MeSH Terms
Abortion, Induced / adverse effects*
Abortion, Spontaneous / surgery*
Case-Control Studies
Dilatation and Curettage / adverse effects*
Endometrium / injuries*
Myometrium / injuries
Placenta Accreta / etiology*
Placenta, Retained / etiology,  therapy
Pregnancy Outcome
Prospective Studies
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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