Lifesaving diagnosis of placenta accreta spectrum using MRI: Report of five cases

Belinda Koesmarsono1, Rozi Aditya Aryananda2, Grace Ariani3

  • 1Department of Radiology, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.

Placenta accreta spectrum (PAS) is defined as abnormal placental adherence or invasion of the myometrium or extrauterine organs. This case series will analyze MRI findings and PAS grading, in addition to emergency situations like massive hematuria and placental invasion with rupture. We report 5 cases of pregnant women with placenta previa with suspected PAS. MRI revealed 1 case of placenta accreta, one case of placenta increta, and 3 cases of placenta percreta. Two cases were emergency situations. All cases were managed with cesarean section. PAS is frequently related to severe obstetric hemorrhage associated with high maternal morbidity and mortality, making diagnosis and management challenging. Ultrasound is the initial diagnostic modality for PAS. Although ultrasound is preferred for PAS diagnosis, MRI provides an effective modality for the analysis of the depth of placental invasion and can be helpful in emergency situations.

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