Controversies in family planning: management of second-trimester pregnancy terminations complicated by placenta accreta.

The following case has come to the attention of our service: a 32-year-old, G2P1001, with a history of one cesarean section, presented at 17–18 weeks' gestation with preterm premature rupture of membranes (PPROM), heavy bleeding and a placenta previa highly suspicious for an accreta on MRI. She received 2 units of packed red cells upon admission to another service and is now in stable condition and in need of a termination of pregnancy. I am curious as to people's experiences and management strategies in these cases. Any thoughts or literature you can point us toward would be appreciated.