Abstract
Discussion Forum (0)
Obstetrics
Placenta Previa During Second-Trimester Abortion and the Risk of Adverse Outcomes: A Systematic Review and Meta-analysis (ID: 1352)
Puja Patel MD, Abdulla M. Al Khan MD, Melissa Marie Figueroa MD, Manuel Alvarez MD, Tomi Kanninen MD
Placenta Previa During Second-Trimester Abortion and the Risk of Adverse Outcomes: A Systematic Review and Meta-analysis (ID: 1352)
Puja Patel MD, Abdulla M. Al Khan MD, Melissa Marie Figueroa MD, Manuel Alvarez MD, Tomi Kanninen MD
INTRODUCTION:
The objective was to systematically review currently available evidence on the rate of adverse outcomes with placenta previa during dilation and evacuation during second-trimester abortion.
METHODS:
PubMed, ScienceDirect, Cochrane Library, and ClincalTrials.gov were reviewed from their inception to June 2024. We included all studies comparing adverse outcomes in second-trimester abortions by dilation and evacuation in women with and without placenta previa. Bias was evaluated using the Newcastle-Ottawa Scale.
RESULTS:
We identified three studies with 118 in the placenta previa group, and 931 in the control. In patients with placenta previa, the risk of transfusion was not significantly increased (relative risk [RR] 2.59; 95% CI, 0.68, 9.81) compared to the control group. However, there was a significant rate of severe blood loss in patients with placenta previas (RR 3.08; 95% CI, 1.60, 5.94) compared to the controls. The rate of overall blood loss (RR 34.36; 95% CI, −14.58, 83.30), hysterectomies (RR 6.03; 95% CI, 0.38, 95.58), operative time (RR 0.28; 95% CI, −2.24, 2.79), time to discharge (mean difference −2.60; 95% CI, −16.64, 11.44), infection (RR 4.70; 95% CI, 0.30, 72.36), and subanalysis for transfusions in patients with complete placenta previas (RR 3.83; 95% CI, 0.82, 17.83) were not significantly different.
CONCLUSIONS/IMPLICATIONS:
The presence of placenta previa at time of second-trimester dilation and evacuation was not associated with transfusion, hysterectomies, overall blood loss, operative time, time to discharge and infection. However, there was significant increase in severe blood loss. This data provides reassurance on safety of dilation and evacuations in the setting of placenta previa.
DOI: 10.1097/AOG.0000000000005917.074
The objective was to systematically review currently available evidence on the rate of adverse outcomes with placenta previa during dilation and evacuation during second-trimester abortion.
METHODS:
PubMed, ScienceDirect, Cochrane Library, and ClincalTrials.gov were reviewed from their inception to June 2024. We included all studies comparing adverse outcomes in second-trimester abortions by dilation and evacuation in women with and without placenta previa. Bias was evaluated using the Newcastle-Ottawa Scale.
RESULTS:
We identified three studies with 118 in the placenta previa group, and 931 in the control. In patients with placenta previa, the risk of transfusion was not significantly increased (relative risk [RR] 2.59; 95% CI, 0.68, 9.81) compared to the control group. However, there was a significant rate of severe blood loss in patients with placenta previas (RR 3.08; 95% CI, 1.60, 5.94) compared to the controls. The rate of overall blood loss (RR 34.36; 95% CI, −14.58, 83.30), hysterectomies (RR 6.03; 95% CI, 0.38, 95.58), operative time (RR 0.28; 95% CI, −2.24, 2.79), time to discharge (mean difference −2.60; 95% CI, −16.64, 11.44), infection (RR 4.70; 95% CI, 0.30, 72.36), and subanalysis for transfusions in patients with complete placenta previas (RR 3.83; 95% CI, 0.82, 17.83) were not significantly different.
CONCLUSIONS/IMPLICATIONS:
The presence of placenta previa at time of second-trimester dilation and evacuation was not associated with transfusion, hysterectomies, overall blood loss, operative time, time to discharge and infection. However, there was significant increase in severe blood loss. This data provides reassurance on safety of dilation and evacuations in the setting of placenta previa.
DOI: 10.1097/AOG.0000000000005917.074
Obstetrics
Placenta Previa During Second-Trimester Abortion and the Risk of Adverse Outcomes: A Systematic Review and Meta-analysis (ID: 1352)
Puja Patel MD, Abdulla M. Al Khan MD, Melissa Marie Figueroa MD, Manuel Alvarez MD, Tomi Kanninen MD
Placenta Previa During Second-Trimester Abortion and the Risk of Adverse Outcomes: A Systematic Review and Meta-analysis (ID: 1352)
Puja Patel MD, Abdulla M. Al Khan MD, Melissa Marie Figueroa MD, Manuel Alvarez MD, Tomi Kanninen MD
INTRODUCTION:
The objective was to systematically review currently available evidence on the rate of adverse outcomes with placenta previa during dilation and evacuation during second-trimester abortion.
METHODS:
PubMed, ScienceDirect, Cochrane Library, and ClincalTrials.gov were reviewed from their inception to June 2024. We included all studies comparing adverse outcomes in second-trimester abortions by dilation and evacuation in women with and without placenta previa. Bias was evaluated using the Newcastle-Ottawa Scale.
RESULTS:
We identified three studies with 118 in the placenta previa group, and 931 in the control. In patients with placenta previa, the risk of transfusion was not significantly increased (relative risk [RR] 2.59; 95% CI, 0.68, 9.81) compared to the control group. However, there was a significant rate of severe blood loss in patients with placenta previas (RR 3.08; 95% CI, 1.60, 5.94) compared to the controls. The rate of overall blood loss (RR 34.36; 95% CI, −14.58, 83.30), hysterectomies (RR 6.03; 95% CI, 0.38, 95.58), operative time (RR 0.28; 95% CI, −2.24, 2.79), time to discharge (mean difference −2.60; 95% CI, −16.64, 11.44), infection (RR 4.70; 95% CI, 0.30, 72.36), and subanalysis for transfusions in patients with complete placenta previas (RR 3.83; 95% CI, 0.82, 17.83) were not significantly different.
CONCLUSIONS/IMPLICATIONS:
The presence of placenta previa at time of second-trimester dilation and evacuation was not associated with transfusion, hysterectomies, overall blood loss, operative time, time to discharge and infection. However, there was significant increase in severe blood loss. This data provides reassurance on safety of dilation and evacuations in the setting of placenta previa.
DOI: 10.1097/AOG.0000000000005917.074
The objective was to systematically review currently available evidence on the rate of adverse outcomes with placenta previa during dilation and evacuation during second-trimester abortion.
METHODS:
PubMed, ScienceDirect, Cochrane Library, and ClincalTrials.gov were reviewed from their inception to June 2024. We included all studies comparing adverse outcomes in second-trimester abortions by dilation and evacuation in women with and without placenta previa. Bias was evaluated using the Newcastle-Ottawa Scale.
RESULTS:
We identified three studies with 118 in the placenta previa group, and 931 in the control. In patients with placenta previa, the risk of transfusion was not significantly increased (relative risk [RR] 2.59; 95% CI, 0.68, 9.81) compared to the control group. However, there was a significant rate of severe blood loss in patients with placenta previas (RR 3.08; 95% CI, 1.60, 5.94) compared to the controls. The rate of overall blood loss (RR 34.36; 95% CI, −14.58, 83.30), hysterectomies (RR 6.03; 95% CI, 0.38, 95.58), operative time (RR 0.28; 95% CI, −2.24, 2.79), time to discharge (mean difference −2.60; 95% CI, −16.64, 11.44), infection (RR 4.70; 95% CI, 0.30, 72.36), and subanalysis for transfusions in patients with complete placenta previas (RR 3.83; 95% CI, 0.82, 17.83) were not significantly different.
CONCLUSIONS/IMPLICATIONS:
The presence of placenta previa at time of second-trimester dilation and evacuation was not associated with transfusion, hysterectomies, overall blood loss, operative time, time to discharge and infection. However, there was significant increase in severe blood loss. This data provides reassurance on safety of dilation and evacuations in the setting of placenta previa.
DOI: 10.1097/AOG.0000000000005917.074
Placenta Previa During Second Trimester Abortion and the Risk of Adverse Outcomes: A Systematic Review and Meta-Analysis
Puja Patel
Affiliations:
null
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Abstract
Discussion Forum (0)
Obstetrics
Placenta Previa During Second-Trimester Abortion and the Risk of Adverse Outcomes: A Systematic Review and Meta-analysis (ID: 1352)
Puja Patel MD, Abdulla M. Al Khan MD, Melissa Marie Figueroa MD, Manuel Alvarez MD, Tomi Kanninen MD
Placenta Previa During Second-Trimester Abortion and the Risk of Adverse Outcomes: A Systematic Review and Meta-analysis (ID: 1352)
Puja Patel MD, Abdulla M. Al Khan MD, Melissa Marie Figueroa MD, Manuel Alvarez MD, Tomi Kanninen MD
INTRODUCTION:
The objective was to systematically review currently available evidence on the rate of adverse outcomes with placenta previa during dilation and evacuation during second-trimester abortion.
METHODS:
PubMed, ScienceDirect, Cochrane Library, and ClincalTrials.gov were reviewed from their inception to June 2024. We included all studies comparing adverse outcomes in second-trimester abortions by dilation and evacuation in women with and without placenta previa. Bias was evaluated using the Newcastle-Ottawa Scale.
RESULTS:
We identified three studies with 118 in the placenta previa group, and 931 in the control. In patients with placenta previa, the risk of transfusion was not significantly increased (relative risk [RR] 2.59; 95% CI, 0.68, 9.81) compared to the control group. However, there was a significant rate of severe blood loss in patients with placenta previas (RR 3.08; 95% CI, 1.60, 5.94) compared to the controls. The rate of overall blood loss (RR 34.36; 95% CI, −14.58, 83.30), hysterectomies (RR 6.03; 95% CI, 0.38, 95.58), operative time (RR 0.28; 95% CI, −2.24, 2.79), time to discharge (mean difference −2.60; 95% CI, −16.64, 11.44), infection (RR 4.70; 95% CI, 0.30, 72.36), and subanalysis for transfusions in patients with complete placenta previas (RR 3.83; 95% CI, 0.82, 17.83) were not significantly different.
CONCLUSIONS/IMPLICATIONS:
The presence of placenta previa at time of second-trimester dilation and evacuation was not associated with transfusion, hysterectomies, overall blood loss, operative time, time to discharge and infection. However, there was significant increase in severe blood loss. This data provides reassurance on safety of dilation and evacuations in the setting of placenta previa.
DOI: 10.1097/AOG.0000000000005917.074
The objective was to systematically review currently available evidence on the rate of adverse outcomes with placenta previa during dilation and evacuation during second-trimester abortion.
METHODS:
PubMed, ScienceDirect, Cochrane Library, and ClincalTrials.gov were reviewed from their inception to June 2024. We included all studies comparing adverse outcomes in second-trimester abortions by dilation and evacuation in women with and without placenta previa. Bias was evaluated using the Newcastle-Ottawa Scale.
RESULTS:
We identified three studies with 118 in the placenta previa group, and 931 in the control. In patients with placenta previa, the risk of transfusion was not significantly increased (relative risk [RR] 2.59; 95% CI, 0.68, 9.81) compared to the control group. However, there was a significant rate of severe blood loss in patients with placenta previas (RR 3.08; 95% CI, 1.60, 5.94) compared to the controls. The rate of overall blood loss (RR 34.36; 95% CI, −14.58, 83.30), hysterectomies (RR 6.03; 95% CI, 0.38, 95.58), operative time (RR 0.28; 95% CI, −2.24, 2.79), time to discharge (mean difference −2.60; 95% CI, −16.64, 11.44), infection (RR 4.70; 95% CI, 0.30, 72.36), and subanalysis for transfusions in patients with complete placenta previas (RR 3.83; 95% CI, 0.82, 17.83) were not significantly different.
CONCLUSIONS/IMPLICATIONS:
The presence of placenta previa at time of second-trimester dilation and evacuation was not associated with transfusion, hysterectomies, overall blood loss, operative time, time to discharge and infection. However, there was significant increase in severe blood loss. This data provides reassurance on safety of dilation and evacuations in the setting of placenta previa.
DOI: 10.1097/AOG.0000000000005917.074
Obstetrics
Placenta Previa During Second-Trimester Abortion and the Risk of Adverse Outcomes: A Systematic Review and Meta-analysis (ID: 1352)
Puja Patel MD, Abdulla M. Al Khan MD, Melissa Marie Figueroa MD, Manuel Alvarez MD, Tomi Kanninen MD
Placenta Previa During Second-Trimester Abortion and the Risk of Adverse Outcomes: A Systematic Review and Meta-analysis (ID: 1352)
Puja Patel MD, Abdulla M. Al Khan MD, Melissa Marie Figueroa MD, Manuel Alvarez MD, Tomi Kanninen MD
INTRODUCTION:
The objective was to systematically review currently available evidence on the rate of adverse outcomes with placenta previa during dilation and evacuation during second-trimester abortion.
METHODS:
PubMed, ScienceDirect, Cochrane Library, and ClincalTrials.gov were reviewed from their inception to June 2024. We included all studies comparing adverse outcomes in second-trimester abortions by dilation and evacuation in women with and without placenta previa. Bias was evaluated using the Newcastle-Ottawa Scale.
RESULTS:
We identified three studies with 118 in the placenta previa group, and 931 in the control. In patients with placenta previa, the risk of transfusion was not significantly increased (relative risk [RR] 2.59; 95% CI, 0.68, 9.81) compared to the control group. However, there was a significant rate of severe blood loss in patients with placenta previas (RR 3.08; 95% CI, 1.60, 5.94) compared to the controls. The rate of overall blood loss (RR 34.36; 95% CI, −14.58, 83.30), hysterectomies (RR 6.03; 95% CI, 0.38, 95.58), operative time (RR 0.28; 95% CI, −2.24, 2.79), time to discharge (mean difference −2.60; 95% CI, −16.64, 11.44), infection (RR 4.70; 95% CI, 0.30, 72.36), and subanalysis for transfusions in patients with complete placenta previas (RR 3.83; 95% CI, 0.82, 17.83) were not significantly different.
CONCLUSIONS/IMPLICATIONS:
The presence of placenta previa at time of second-trimester dilation and evacuation was not associated with transfusion, hysterectomies, overall blood loss, operative time, time to discharge and infection. However, there was significant increase in severe blood loss. This data provides reassurance on safety of dilation and evacuations in the setting of placenta previa.
DOI: 10.1097/AOG.0000000000005917.074
The objective was to systematically review currently available evidence on the rate of adverse outcomes with placenta previa during dilation and evacuation during second-trimester abortion.
METHODS:
PubMed, ScienceDirect, Cochrane Library, and ClincalTrials.gov were reviewed from their inception to June 2024. We included all studies comparing adverse outcomes in second-trimester abortions by dilation and evacuation in women with and without placenta previa. Bias was evaluated using the Newcastle-Ottawa Scale.
RESULTS:
We identified three studies with 118 in the placenta previa group, and 931 in the control. In patients with placenta previa, the risk of transfusion was not significantly increased (relative risk [RR] 2.59; 95% CI, 0.68, 9.81) compared to the control group. However, there was a significant rate of severe blood loss in patients with placenta previas (RR 3.08; 95% CI, 1.60, 5.94) compared to the controls. The rate of overall blood loss (RR 34.36; 95% CI, −14.58, 83.30), hysterectomies (RR 6.03; 95% CI, 0.38, 95.58), operative time (RR 0.28; 95% CI, −2.24, 2.79), time to discharge (mean difference −2.60; 95% CI, −16.64, 11.44), infection (RR 4.70; 95% CI, 0.30, 72.36), and subanalysis for transfusions in patients with complete placenta previas (RR 3.83; 95% CI, 0.82, 17.83) were not significantly different.
CONCLUSIONS/IMPLICATIONS:
The presence of placenta previa at time of second-trimester dilation and evacuation was not associated with transfusion, hysterectomies, overall blood loss, operative time, time to discharge and infection. However, there was significant increase in severe blood loss. This data provides reassurance on safety of dilation and evacuations in the setting of placenta previa.
DOI: 10.1097/AOG.0000000000005917.074
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