Second trimester termination of pregnancy complicated by abnormal placentation

Abstract

Introduction: The presence of placenta praevia or a morbidly adherent placenta with or without co-existing previous caesarean sections can complicate 2.3% of second trimester terminations of pregnancy. Potential lifethreatening haemorrhage can pose significant risks to the patient. Available guidance on second trimester terminations does not distinguish between cases with or without abnormal placentation and/ or previous caesarean deliveries. Case Series: We present our experience with three cases requiring termination of pregnancy for foetal anomalies. The first patient presented with placenta accreta, the second had placenta praevia and the third patient had 3 previous caesarean sections and placenta praevia. They were managed differently and had varying outcomes. A search of the existing literature demonstrated that there is a lack of evidence to suggest the most appropriate method of management of these difficult clinical situations. Conclusion: These isolated cases need to be reported, to constitute a base for collective evidence in the future to inform optimal management.