{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:53:18Z","timestamp":1780966398652,"version":"3.54.1"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T00:00:00Z","timestamp":1753142400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T00:00:00Z","timestamp":1753142400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp;amp; Obste"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe early second\u2010trimester placenta accreta spectrum (PAS) management and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross\u2010sectional 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\u2009weeks of gestation and in\u2010hospital management. Descriptive analysis was performed to: (1) characterize PAS management variations at the intention\u2010to\u2010treat level and need for conversion to hysterectomy at the per\u2010procedure level, and (2) evaluate maternal morbidity compared with 5365 cesarean hysterectomies for PAS between 34 and 36\u2009weeks of gestation via generalized linear modeling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Early second\u2010trimester 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\u2010procedure analysis noted an unplanned hysterectomy rate of 51.9% and 45.8% following induced abortion and dilation and evacuation, respectively. Comparing 14\u201316\u2009weeks with 20\u201322\u2009weeks of gestation, the proportion of cases managed via induction abortion (22.6%\u201333.3%), gravid hysterectomy (12.9%\u201329.8%), and hysterotomy alone (0%\u20139.5%) increased while dilation and evacuation (22.6% to &lt;3.0%) decreased (\n                      <jats:italic>P<\/jats:italic>\n                      \u2010trend &lt;0.01). Increta and percreta were more frequently implicated in second\u2010trimester gravid versus third\u2010trimester cesarean hysterectomy (adjusted prevalence ratio, 1.69 [95% confidence interval (CI), 1.40\u20132.05]). Compared with third\u2010trimester cesarean hysterectomy, second\u2010trimester gravid hysterectomy demonstrated higher incidences of hemorrhage\/blood transfusion (adjusted incidence ratio [aIR], 1.17 [95% CI, 1.01\u20131.36]); shock\/coagulopathy (aIR, 3.57 [95% CI, 2.75\u20134.63]); and hospitalization \u22657\u2009days (aIR, 2.27 [95% CI, 1.87\u20132.75]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These data suggest heterogeneity in the management of early second\u2010trimester PAS. Morbidity associated with early second\u2010trimester PAS was substantial regardless of the management approach, highlighting the need for standardized guidelines.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70372","type":"journal-article","created":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T08:54:23Z","timestamp":1753174463000},"page":"622-629","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Obstetric characteristics and maternal outcomes of early second\u2010trimester placenta accreta spectrum"],"prefix":"10.1002","volume":"172","author":[{"given":"Mihiri S.","family":"Karunaratne","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Los Angeles General Medical Center  Los Angeles California USA"},{"name":"Department of Obstetrics and Gynecology University of Southern California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinya","family":"Matsuzaki","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Osaka University Graduate School of Medicine  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhide","family":"Matsushima","sequence":"additional","affiliation":[{"name":"Division of Acute Care Surgery, Department of Surgery University of Southern California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane L.","family":"Yang","sequence":"additional","affiliation":[{"name":"Keck School of Medicine, University of Southern California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel S.","family":"Mandelbaum","sequence":"additional","affiliation":[{"name":"Division of Reproductive Endocrinology &amp; Infertility, Department of Obstetrics and Gynecology University of Southern California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laila I.","family":"Muderspach","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Los Angeles General Medical Center  Los Angeles California USA"},{"name":"Division of Gynecologic Oncology, Department of Obstetrics and Gynecology University of Southern California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph G.","family":"Ouzounian","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Department of Obstetrics and Gynecology University of Southern California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6232-8701","authenticated-orcid":false,"given":"Koji","family":"Matsuo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Los Angeles General Medical Center  Los Angeles California USA"},{"name":"Division of Gynecologic Oncology, Department of Obstetrics and Gynecology University of Southern California  Los Angeles California USA"},{"name":"Norris Comprehensive Cancer Center University of Southern California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0282-3241","authenticated-orcid":false,"given":"Brian T.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Division of Complex Family Planning, Department of Obstetrics and Gynecology University of Southern California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,22]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2021.04.233"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2023.10.001"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2018.09.042"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0029-7844(95)00050-2"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2011.576722"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2017.03.028"},{"issue":"1","key":"e_1_2_10_8_1","first-page":"e6","article-title":"A case report and literature review of Midtrimester termination of pregnancy complicated by placenta Previa and placenta Accreta","volume":"5","author":"Matsuzaki S","year":"2015","journal-title":"AJP Rep"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2024.07.045"},{"key":"e_1_2_10_10_1","unstructured":"Agency for Healthcare Research and Quality.Overview of the National (Nationwide) Inpatient Sample (NIS). 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