ArticleInternational journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics2026
Obstetric characteristics and maternal outcomes of early second-trimester placenta accreta spectrum.
Article in International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- DARIP Technique: A Novel Approach in the Surgical Management of Placenta Accreta Spectrum in the Second Trimester From Tu Du Hospital, Vietnam.Case reports in obstetrics and gynecology · 2026Article
- Obstetric characteristics and maternal outcomes of early second-trimester placenta accreta spectrum.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
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9 authors.
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Abstract
objectiveTo describe early second-trimester placenta accreta spectrum (PAS) management and outcomes.
methodsThis cross-sectional study queried the US Healthcare Cost and Utilization Project's National Inpatient Sample from 2016 to 2021, finding 905 cases with a diagnosis of PAS between 14 and 22 weeks of gestation and in-hospital management. Descriptive analysis was performed to: (1) characterize PAS management variations at the intention-to-treat level and need for conversion to hysterectomy at the per-procedure level, and (2) evaluate maternal morbidity compared with 5365 cesarean hysterectomies for PAS between 34 and 36 weeks of gestation via generalized linear modeling.
resultsEarly second-trimester PAS was managed most frequently via induction abortion (29.8%), followed by gravid hysterectomy (23.2%), dilation and evacuation (13.3%), and hysterotomy alone (6.6%). Per-procedure analysis noted an unplanned hysterectomy rate of 51.9% and 45.8% following induced abortion and dilation and evacuation, respectively. Comparing 14-16 weeks with 20-22 weeks of gestation, the proportion of cases managed via induction abortion (22.6%-33.3%), gravid hysterectomy (12.9%-29.8%), and hysterotomy alone (0%-9.5%) increased while dilation and evacuation (22.6% to <3.0%) decreased (P-trend <0.01). Increta and percreta were more frequently implicated in second-trimester gravid versus third-trimester cesarean hysterectomy (adjusted prevalence ratio, 1.69 [95% confidence interval (CI), 1.40-2.05]). Compared with third-trimester cesarean hysterectomy, second-trimester gravid hysterectomy demonstrated higher incidences of hemorrhage/blood transfusion (adjusted incidence ratio [aIR], 1.17 [95% CI, 1.01-1.36]); shock/coagulopathy (aIR, 3.57 [95% CI, 2.75-4.63]); and hospitalization ≥7 days (aIR, 2.27 [95% CI, 1.87-2.75]).
conclusionThese data suggest heterogeneity in the management of early second-trimester PAS. Morbidity associated with early second-trimester PAS was substantial regardless of the management approach, highlighting the need for standardized guidelines.
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