IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Placenta accreta

Case contributed by Simon Meagher
Diagnosis certain

Presentation

Placental re-assessment at 33 weeks gestation.

Antenatal ultrasound

ultrasound

Transabdominal and transvaginal ultrasound demonstrate an abnormally low position of the placenta, covering the anterior lower uterine segment, and also the internal cervical os, in keeping with a major grade placenta previa.  

Multiple blood filled spaces are noted throughout the placenta (placental lacunae), a finding associated with abnormal placental adherence.

There is marked thinning of the anterior myometrium, with no appreciable myometrial tissue demonstrated between the placenta and the bladder serosa.

Color imaging further supports the diagnosis, with marked placental vascularity and increased vascularity of the uterine-bladder interface

Case Discussion

Abnormal placental adherence is an important cause of maternal peripartum morbidity and mortality due to massive hemorrhage.  

Awareness of the sonographic findings and vigilant imaging of patients with risk factors - in particular placenta previa and multiple previous Cesarian sections - increases the likelihood of accurate prenatal diagnosis. 

This in turn enables adequate pre-operative preparation, such as planned delivery at a tertiary institution, and preparation of a large quantity of crossmatched red blood cells.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.