1/2. placenta accreta and intrauterine fetal death in a woman with prior endometrial ablation: a case report.BACKGROUND: Few cases of pregnancy following endometrial ablation have been reported. placenta accreta and poor perinatal outcome are potential risks due to underlying endometrial destruction and uterine scarring. CASE: A 41-year-old, white woman presented for initial prenatal care at 12 weeks, 3 years after endometrial ablation with resection of a leiomyoma. The patient's prenatal care was unremarkable until 20 weeks, when she presented with intrauterine fetal death. Labor was induced with misoprostol, and a stillborn fetus resulted. The placenta failed to deliver spontaneously after 6 hours and continuing doses of misoprostol. An attempt at manual extraction failed to demonstrate a clear cleavage plane between the placenta and endometrium. The patient underwent a hysterectomy for placenta accreta, which was confirmed on pathology. CONCLUSION: Endometrial ablation may predispose the patient to abnormal placentation and intrauterine fetal death. physicians should counsel their patients appropriately about the likelihood of this outcome.- - - - - - - - - - ranking = 1keywords = endometrial ablation, ablation (Clic here for more details about this article) |
2/2. Premature rupture of membranes, placenta increta, and hysterectomy in a pregnancy following endometrial ablation.Endometrial ablation has become a popular method of managing menorrhagia. pregnancy after endometrial ablation has a high rate of complications. We present the case of a parous woman with a history of endometrial ablation with preterm premature rupture of membranes. Despite the absence of established sonographic markers for abnormal placentation, placenta accreta was noted at the time of cesarean delivery. In women with history of endometrial ablation, the endometrium is not normal and may allow for more aggressive placental invasion or adherence. Consequently, the sonographic indices described for evaluating placenta accreta may not be present. We believe that placentation in women with prior endometrial ablations should be considered extremely high risk for placenta accreta or increta and managed accordingly when preparing for delivery.- - - - - - - - - - ranking = 1.166731068519keywords = endometrial ablation, ablation (Clic here for more details about this article) |