Placental abruption

Case contributed by Dr Seamus O'Flaherty

Presentation

Female with obesity and pre-eclampsia at 36 weeks gestation. For growth scan. No further clinical information provided.

Patient Data

Age: 40 years
Gender: Female
Ultrasound

The placental position is anterior and is clear of the cervical os by 8cm. The placenta demonstrates a region of heterogeneous echotexture that measures 83x59x91mm. There is no flow within this region and there is an adjacent cystic focus caudally.

Umbilical artery S/D ratio is 3.1 (normal). Fetal position, measurements and heart rate are normal. Liquor volume is normal. The cervical os is closed. (not shown). 

Case Discussion

This 40 year old female at 36 weeks gestation was referred for a growth scan on background of pre-eclampsia. 

The ultrasound demonstrated a large intra-placental hematoma, indicative of placental abruption. Pre-eclampsia is a major risk factor, present in up to 50% of cases.  

The fetus appeared normal at the time of scanning, however, became distressed shortly after and an emergency cesarian was performed.

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