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Placenta accreta. Additional sonographic observations.

J C Hoffman-Tretin1, M Koenigsberg, A Rabin

  • 1Department of Radiology (Division of Ultrasound), Bronx Municipal Hospital Center, New York.

Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine
|January 1, 1992
PubMed
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Diagnosing placenta accreta antenatally is possible by noting the absence of a hypoechoic zone. New ultrasound findings, including venous lakes and abnormal vascularity, aid in diagnosis.

Area of Science:

  • Obstetrics and Gynecology
  • Fetal Medicine
  • Diagnostic Imaging

Background:

  • Placenta accreta presents diagnostic challenges in prenatal care.
  • Previous reports suggest sonographic detection based on specific placental margin characteristics.

Purpose of the Study:

  • To evaluate antenatal sonographic findings for diagnosing placenta accreta.
  • To identify new sonographic markers associated with placenta accreta.

Main Methods:

  • Retrospective analysis of seven cases with antenatal sonographic diagnosis of placenta accreta.
  • Sonographic evaluation included visualization of the retroplacental hypoechoic zone, placental venous lakes, periuterine vascularity, and Doppler flow patterns.
  • Histopathologic correlation was performed.

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Main Results:

  • Failure to visualize the retroplacental hypoechoic zone confirmed placenta accreta diagnosis.
  • Prominent placental venous lakes and periuterine vascularity were observed in six cases.
  • Progressive thinning/disappearance of the hypoechoic zone and altered Doppler flow patterns were noted in some cases.

Conclusions:

  • Antenatal sonography, particularly assessing the retroplacental hypoechoic zone, is valuable for diagnosing placenta accreta.
  • Placental venous lakes and periuterine vascularity are potential additional sonographic markers.
  • Histologic findings support the sonographic observations, linking them to decidual deficiency.