{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T09:01:18Z","timestamp":1767171678675,"version":"build-2238731810"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,8,18]],"date-time":"2021-08-18T00:00:00Z","timestamp":1629244800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,8,18]],"date-time":"2021-08-18T00:00:00Z","timestamp":1629244800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pregnancy Childbirth"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Backgrounds<\/jats:title>\n                    <jats:p>Pregnancy termination during the second trimester in patients with placenta previa and placenta accreta spectrum (PAS) is a complex and challenging clinical problem. Based on our literature review, there has been a relative increase in the number of such cases being treated by hysterotomy and\/or local uterine lesion resection and repair. In the present study, a retrospective analysis was conducted to compare the clinical outcomes when different management strategies were used to terminate pregnancy in the patients with placenta previa and PAS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 51 patients who underwent pregnancy termination in the second trimester in Beijing Obstetrics and Gynecology Hospital between June 2013 and December 2018 were retrospectively analyzed in this study. All patients having previous caesarean delivery (CD) were diagnosed with placenta previa status and PAS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      \u2460 Among the 51 patients, 16 cases received mifepristone and misoprostol medical termination, 15 cases received mifepristone and Rivanol medical termination, but 1 of them was transferred to hysterotomy due to failed labor induction, another 20 cases were performed planned hysterotomy. There was no placenta percreta cases and uterine artery embolization (UAE) was all performed before surgery.\u2461 There were 31 cases who underwent medical termination and 30 cases were vaginal delivery. Dilation and evacuation (D&amp;E) were used in 20 cases of medical abortion failure and in all 30 cases of difficult manual removal of placental tissue. \u2462 A statistically significant difference was found among the three different strategies in terms of gestational weeks, the type of placenta previa status, main operative success rate and \u03b2-HCG regression time (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05). \u2463 There were 4(7.8%) cases who were taken up for hysterectomy because of life-threatening bleeding or severe bacteremia during or after delivery and hysterotomy. The uterus was preserved with the implanted placenta partly or completely left in situ in 47(92.2%) cases. Combined medical and\/or surgical management were used for the residual placenta and the time of menstrual recovery was 52(range: 33 to 86) days after pregnancy termination.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Terminating a pregnancy by vaginal delivery through medical induction of labor may be feasible if clinicians have an overall understanding of gestational age, the type of placenta previa status, the type of placenta accreta, and patients concerns about preserving fertility. A collaborative team effort in tertiary medical centers with a very experience MDT and combined application of multiple methods is required to optimize patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12884-021-04017-8","type":"journal-article","created":{"date-parts":[[2021,8,18]],"date-time":"2021-08-18T10:04:30Z","timestamp":1629281070000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Clinical analysis of second-trimester pregnancy termination after previous caesarean delivery in 51 patients with placenta previa and placenta accreta spectrum: a retrospective study"],"prefix":"10.1186","volume":"21","author":[{"given":"Qiaofei","family":"Hu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Changdong","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lanrong","family":"Luo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaofeng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suwen","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaokui","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,8,18]]},"reference":[{"key":"4017_CR1","doi-asserted-by":"crossref","unstructured":"Cali G, Timor-Tritsch IE, Palacios-Jaraquemada J, Monteaugudo A, Buca D, Forlani F, Familiari A, Scambia G, Acharya G, D\u2019Antonio F. Outcome of Cesarean scar pregnancy managed expectantly: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2018;51(2):169\u201375.","DOI":"10.1002\/uog.17568"},{"key":"4017_CR2","doi-asserted-by":"crossref","unstructured":"Zhang Y, Zhang Z, Liu X, Zhang L, Hong F, Lu M. Risk factors for massive hemorrhage during the treatment of cesarean scar pregnancy: a systematic review and meta-analysis. Arch Gynecol Obstet. 2021;303(2):321\u20138.","DOI":"10.1007\/s00404-020-05877-9"},{"issue":"7","key":"4017_CR3","doi-asserted-by":"publisher","first-page":"488","DOI":"10.2471\/BLT.11.093369","volume":"90","author":"M Runmei","year":"2012","unstructured":"Runmei M, Terence TL, Yonghu S, Hong X, Yuqin T, Bailuan L, Minghui Y, Weihong Y, Kun L, Guohua L, et al. Practice audits to reduce caesareans in a tertiary referral hospital in south-western China. Bull World Health Organ. 2012;90(7):488\u201394.","journal-title":"Bull World Health Organ"},{"issue":"7","key":"4017_CR4","doi-asserted-by":"publisher","first-page":"621","DOI":"10.3109\/01443615.2012.698665","volume":"32","author":"P Sinha","year":"2012","unstructured":"Sinha P, Mishra M. Caesarean scar pregnancy: a precursor of placenta percreta\/accreta. J Obstet Gynaecol. 2012;32(7):621\u20133.","journal-title":"J Obstet Gynaecol"},{"key":"4017_CR5","doi-asserted-by":"publisher","unstructured":"Sikka P, Suri V, Chopra S, Aggarwal N. A second trimester caesarean scar pregnancy. Case Rep Obstet Gynecol. 2014;2014:828635.\u00a0https:\/\/doi.org\/10.1155\/2014\/828635.","DOI":"10.1155\/2014\/828635"},{"issue":"3","key":"4017_CR6","doi-asserted-by":"publisher","first-page":"346","DOI":"10.1002\/uog.13426","volume":"44","author":"IE Timor-Tritsch","year":"2014","unstructured":"Timor-Tritsch IE, Monteagudo A, Cali G, Vintzileos A, Viscarello R, Al-Khan A, Zamudio S, Mayberry P, Cordoba MM, Dar P. Cesarean scar pregnancy is a precursor of morbidly adherent placenta. Ultrasound Obstet Gynecol. 2014;44(3):346\u201353.","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"8","key":"4017_CR7","doi-asserted-by":"publisher","first-page":"2011","DOI":"10.1002\/jum.14554","volume":"37","author":"JK Durst","year":"2018","unstructured":"Durst JK, Tuuli MG, Temming LA, Hamilton O, Dicke JM. Resolution of a Low-Lying Placenta and Placenta Previa Diagnosed at the Midtrimester Anatomy Scan. J Ultrasound Med. 2018;37(8):2011\u20139.","journal-title":"J Ultrasound Med"},{"issue":"5","key":"4017_CR8","doi-asserted-by":"publisher","first-page":"745","DOI":"10.7863\/ultra.33.5.745","volume":"33","author":"UM Reddy","year":"2014","unstructured":"Reddy UM, Abuhamad AZ, Levine D, Saade GR. Fetal imaging: executive summary of a joint Eunice Kennedy Shriver National Institute of Child Health and Human Development, Society for Maternal-Fetal Medicine, American Institute of Ultrasound in Medicine, American College of Obstetricians and Gynecologists, American College of Radiology, Society for Pediatric Radiology, and Society of Radiologists in Ultrasound Fetal Imaging Workshop. J Ultrasound Med. 2014;33(5):745\u201357.","journal-title":"J Ultrasound Med"},{"issue":"1","key":"4017_CR9","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1002\/ijgo.12761","volume":"146","author":"E Jauniaux","year":"2019","unstructured":"Jauniaux E, Ayres-de-Campos D, Langhoff-Roos J, Fox KA, Collins S. FIGO classification for the clinical diagnosis of placenta accreta spectrum disorders. Int J Gynaecol Obstet. 2019;146(1):20\u20134.","journal-title":"Int J Gynaecol Obstet"},{"issue":"3","key":"4017_CR10","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1002\/ijgo.12408","volume":"140","author":"E Jauniaux","year":"2018","unstructured":"Jauniaux E, Bhide A, Kennedy A, Woodward P, Hubinont C, Collins S. FIGO consensus guidelines on placenta accreta spectrum disorders: Prenatal diagnosis and screening. Int J Gynaecol Obstet. 2018;140(3):274\u201380.","journal-title":"Int J Gynaecol Obstet"},{"issue":"5","key":"4017_CR11","doi-asserted-by":"publisher","first-page":"1158","DOI":"10.2214\/AJR.07.2417","volume":"189","author":"CH Tan","year":"2007","unstructured":"Tan CH, Tay KH, Sheah K, Kwek K, Wong K, Tan HK, Tan BS. Perioperative endovascular internal iliac artery occlusion balloon placement in management of placenta accreta. AJR Am J Roentgenol. 2007;189(5):1158\u201363.","journal-title":"AJR Am J Roentgenol"},{"issue":"4","key":"4017_CR12","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1053\/j.sult.2015.05.007","volume":"36","author":"MK Shetty","year":"2015","unstructured":"Shetty MK, Dryden DK. Morbidly Adherent Placenta: Ultrasound Assessment and Supplemental Role of Magnetic Resonance Imaging. Semin Ultrasound CT MR. 2015;36(4):324\u201331.","journal-title":"Semin Ultrasound CT MR"},{"issue":"7","key":"4017_CR13","doi-asserted-by":"publisher","first-page":"639","DOI":"10.1016\/j.placenta.2008.04.008","volume":"29","author":"P Tantbirojn","year":"2008","unstructured":"Tantbirojn P, Crum CP, Parast MM. Pathophysiology of placenta creta: the role of decidua and extravillous trophoblast. Placenta. 2008;29(7):639\u201345.","journal-title":"Placenta"},{"issue":"3","key":"4017_CR14","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1002\/ijgo.12410","volume":"140","author":"L Sentilhes","year":"2018","unstructured":"Sentilhes L, Kayem G, Chandraharan E, Palacios-Jaraquemada J, Jauniaux E. FIGO consensus guidelines on placenta accreta spectrum disorders: Conservative management. Int J Gynaecol Obstet. 2018;140(3):291\u20138.","journal-title":"Int J Gynaecol Obstet"},{"issue":"1","key":"4017_CR15","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1016\/j.ajog.2012.03.007","volume":"207","author":"IE Timor-Tritsch","year":"2012","unstructured":"Timor-Tritsch IE, Monteagudo A. Unforeseen consequences of the increasing rate of cesarean deliveries: early placenta accreta and cesarean scar pregnancy A review. Am J Obstet Gynecol. 2012;207(1):14\u201329.","journal-title":"Am J Obstet Gynecol"},{"issue":"1","key":"4017_CR16","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/j.ajog.2017.05.067","volume":"218","author":"E Jauniaux","year":"2018","unstructured":"Jauniaux E, Collins S, Burton GJ. Placenta accreta spectrum: pathophysiology and evidence-based anatomy for prenatal ultrasound imaging. Am J Obstet Gynecol. 2018;218(1):75\u201387.","journal-title":"Am J Obstet Gynecol"},{"issue":"4","key":"4017_CR17","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1097\/GRF.0000000000000392","volume":"61","author":"E Jauniaux","year":"2018","unstructured":"Jauniaux E, Burton GJ. Pathophysiology of Placenta Accreta Spectrum Disorders: A Review of Current Findings. Clin Obstet Gynecol. 2018;61(4):743\u201354.","journal-title":"Clin Obstet Gynecol"},{"issue":"1","key":"4017_CR18","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1016\/j.ajog.2017.02.050","volume":"217","author":"E Jauniaux","year":"2017","unstructured":"Jauniaux E, Bhide A. Prenatal ultrasound diagnosis and outcome of placenta previa accreta after cesarean delivery: a systematic review and meta-analysis. Am J Obstet Gynecol. 2017;217(1):27\u201336.","journal-title":"Am J Obstet Gynecol"},{"issue":"5","key":"4017_CR19","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1515\/jpm-2013-0199","volume":"42","author":"M Klar","year":"2014","unstructured":"Klar M, Michels KB. Cesarean section and placental disorders in subsequent pregnancies\u2013a meta-analysis. J Perinat Med. 2014;42(5):571\u201383.","journal-title":"J Perinat Med"},{"issue":"3","key":"4017_CR20","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1002\/ijgo.12407","volume":"140","author":"E Jauniaux","year":"2018","unstructured":"Jauniaux E, Chantraine F, Silver RM, Langhoff-Roos J. FIGO consensus guidelines on placenta accreta spectrum disorders: Epidemiology. Int J Gynaecol Obstet. 2018;140(3):265\u201373.","journal-title":"Int J Gynaecol Obstet"},{"issue":"1","key":"4017_CR21","first-page":"e6","volume":"5","author":"S Matsuzaki","year":"2015","unstructured":"Matsuzaki S, Matsuzaki S, Ueda Y, Tanaka Y, Kakuda M, Kanagawa T, Kimura T. A Case Report and Literature Review of Midtrimester Termination of Pregnancy Complicated by Placenta Previa and Placenta Accreta. AJP Rep. 2015;5(1):e6\u201311.","journal-title":"AJP Rep"},{"issue":"5 Pt 1","key":"4017_CR22","doi-asserted-by":"publisher","first-page":"701","DOI":"10.1016\/0029-7844(95)00050-2","volume":"85","author":"WK Rashbaum","year":"1995","unstructured":"Rashbaum WK, Gates EJ, Jones J, Goldman B, Morris A, Lyman WD. Placenta accreta encountered during dilation and evacuation in the second trimester. Obstet Gynecol. 1995;85(5 Pt 1):701\u20133.","journal-title":"Obstet Gynecol"},{"issue":"6","key":"4017_CR23","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1080\/01443610400008172","volume":"24","author":"R Khan","year":"2004","unstructured":"Khan R, Hollingworth A. Post-evacuation haemorrhage due to an undiagnosed second trimester placenta accreta\/percreta. J Obstet Gynaecol. 2004;24(6):707\u20138.","journal-title":"J Obstet Gynaecol"},{"issue":"1","key":"4017_CR24","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1016\/j.contraception.2011.08.011","volume":"85","author":"E Lathrop","year":"2012","unstructured":"Lathrop E, Schreiber C. Controversies in family planning: management of second-trimester pregnancy terminations complicated by placenta accreta. Contraception. 2012;85(1):5\u20138.","journal-title":"Contraception"},{"issue":"1","key":"4017_CR25","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1186\/s12884-018-1935-6","volume":"18","author":"R Cui","year":"2018","unstructured":"Cui R, Li M, Lu J, Bai H, Zhang Z. Management strategies for patients with placenta accreta spectrum disorders who underwent pregnancy termination in the second trimester: a retrospective study. BMC Pregnancy Childbirth. 2018;18(1):298.","journal-title":"BMC Pregnancy Childbirth"},{"issue":"5","key":"4017_CR26","doi-asserted-by":"publisher","first-page":"447","DOI":"10.3109\/01443615.2012.669429","volume":"32","author":"VV Wong","year":"2012","unstructured":"Wong VV, Burke G. Planned conservative management of placenta percreta. J Obstet Gynaecol. 2012;32(5):447\u201352.","journal-title":"J Obstet Gynaecol"},{"issue":"1","key":"4017_CR27","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1097\/AOG.0b013e318262e340","volume":"120","author":"Committee opinion no","year":"2012","unstructured":"Committee opinion no. 529: placenta accreta. Obstet Gynecol. 2012;120(1):207\u201311.","journal-title":"Obstet Gynecol"},{"issue":"5","key":"4017_CR28","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1016\/j.ajog.2014.11.018","volume":"212","author":"RM Silver","year":"2015","unstructured":"Silver RM, Fox KA, Barton JR, Abuhamad AZ, Simhan H, Huls CK, Belfort MA, Wright JD. Center of excellence for placenta accreta. Am J Obstet Gynecol. 2015;212(5):561\u20138.","journal-title":"Am J Obstet Gynecol"},{"issue":"3","key":"4017_CR29","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1002\/ijgo.12409","volume":"140","author":"L Allen","year":"2018","unstructured":"Allen L, Jauniaux E, Hobson S, Papillon-Smith J, Belfort MA. FIGO consensus guidelines on placenta accreta spectrum disorders: Nonconservative surgical management. Int J Gynaecol Obstet. 2018;140(3):281\u201390.","journal-title":"Int J Gynaecol Obstet"},{"issue":"3","key":"4017_CR30","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1016\/j.tjog.2017.04.016","volume":"56","author":"HW Su","year":"2017","unstructured":"Su HW, Yi YC, Tseng JJ, Chen WC, Chen YF, Kung HF, Chou MM. Maternal outcome after conservative management of abnormally invasive placenta. Taiwan J Obstet Gynecol. 2017;56(3):353\u20137.","journal-title":"Taiwan J Obstet Gynecol"}],"updated-by":[{"DOI":"10.1186\/s12884-021-04159-9","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2021,10,9]],"date-time":"2021-10-09T00:00:00Z","timestamp":1633737600000}}],"container-title":["BMC Pregnancy and Childbirth"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12884-021-04017-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12884-021-04017-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12884-021-04017-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,10]],"date-time":"2021-10-10T17:36:11Z","timestamp":1633887371000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpregnancychildbirth.biomedcentral.com\/articles\/10.1186\/s12884-021-04017-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,18]]},"references-count":30,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["4017"],"URL":"https:\/\/doi.org\/10.1186\/s12884-021-04017-8","relation":{},"ISSN":["1471-2393"],"issn-type":[{"value":"1471-2393","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,18]]},"assertion":[{"value":"30 March 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 July 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 August 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 October 2021","order":4,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Correction","order":5,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"A Correction to this paper has been published:","order":6,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"https:\/\/doi.org\/10.1186\/s12884-021-04159-9","URL":"https:\/\/doi.org\/10.1186\/s12884-021-04159-9","order":7,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Human Ethics Committees of Beijing Obstetrics and Gynecology Hospital, Capital Medical University. All participants provided informed consent to participate in the study and all methods were carried out in accordance with relevant guidelines and regulations.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"All participants provided consent to the publication of this study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"568"}}