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Am J Perinatol 2018; 35(10): 931-935
DOI: 10.1055/s-0038-1626710
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Pregnancy Outcomes after Endometrial Ablation in a Multi-institutional Cohort

Alison M. Bauer
1   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University Hospitals Cleveland Medical Center, Cleveland, Ohio
,
David N. Hackney
1   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University Hospitals Cleveland Medical Center, Cleveland, Ohio
,
Sherif El-Nashar
2   Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University Hospitals Cleveland Medical Center, Cleveland, Ohio
,
David Sheyn
2   Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University Hospitals Cleveland Medical Center, Cleveland, Ohio
› Author Affiliations Funding None.
Further Information

Publication History

11 August 2017

29 December 2017

Publication Date:
08 February 2018 (online)

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Abstract

Objective The objective of this study was to determine the incidence of morbidly adherent placenta in pregnancies after endometrial ablation.

Study Design We performed a retrospective cohort analysis using a large, multiinstitutional deidentified clinical database, IBM EPM: Explore (IBM Corporation, Somers, NY). We identified women who underwent endometrial ablation and had a subsequent delivery between 1999 and 2016. Patients with a delivery and no prior ablation were used as controls. The association between morbidly adherent placenta, ablation, and other known risk factors for morbidly adherent placenta was analyzed using multivariable logistic regression.

Results Of 162,100 reproductive-aged women who underwent endometrial ablation, 2,770 women (1.71%) subsequently had a delivery. The rate of morbidly adherent placenta was 1 in 13.9 pregnancies after ablation compared with 1 in 838.7 pregnancies in the control group (adjusted odds ratio [aOR], 20.22, p < 0.0001).

Conclusion Pregnancies that occurred after endometrial ablation were associated with increased rates of morbidly adherent placenta.

Keywords

endometrial ablation - placenta accreta - morbidly adherent placenta - pregnancy outcomes
 

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