Placenta accreta encountered during dilation and evacuation in the second trimester.

Objective: To assess the frequency of placenta accreta encountered during dilation and evacuation (D&E) in the second trimester.

Methods: Among 16,827 second-trimester D&E procedures performed at our hospitals and clinics, seven cases of placenta accreta, either suspected clinically or proven histologically, were encountered. These cases were analyzed for history of prior cesarean delivery, placenta localization, and histology of hysterectomy specimens.

Results: Six of the seven cases suspected clinically were confirmed histologically. All placenta accreta patients had at least one cesarean delivery (mean 1.7), and five had a preoperative sonogram demonstrating some form of placenta previa. The prevalence of clinical placenta accreta encountered during D&Es in the second trimester was 0.04%, the same as that reported for placenta accreta diagnosed clinically in the third trimester.

Conclusion: Placenta accreta can be a potential complicating factor in the patient undergoing D&E in the second trimester.