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Sonographic placental sonolucencies, including lakes and lacunae, are ultrasound findings that can indicate normal pregnancy or signal potential complications like placenta accreta spectrum. Understanding their development is key for risk assessment.

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Area of Science:

  • Obstetrics and Gynecology
  • Medical Imaging
  • Fetal Medicine

Background:

  • Sonographic sonolucencies, appearing as anechoic areas in placental parenchyma, are common in the second and third trimesters.
  • These spaces, termed lakes and lacunae, result from maternal blood flow within the intervillous space.
  • Their appearance and development differ between normal placentation and conditions like placenta accreta spectrum.

Purpose of the Study:

  • To elucidate the etiopathology of placental sonolucent spaces (lakes and lacunae).
  • To correlate sonolucent space morphology with pregnancy complications.
  • To improve identification of patients at risk for adverse pregnancy and delivery outcomes.

Main Methods:

  • Descriptive ultrasound analysis of placental parenchyma.
  • Correlation of sonolucent space characteristics with gestational age and placental pathology.
  • Evaluation of associations with fetal growth and maternal conditions.

Main Results:

  • Placental lakes typically appear by the end of the first trimester in normal pregnancies.
  • Lacunae, associated with placenta accreta spectrum, develop progressively in the second trimester, often within uterine scars.
  • While variable lakes are usually benign, echogenic cystic lesions may indicate fetal growth issues and placental malperfusion.

Conclusions:

  • Placental lakes and lacunae have distinct sonographic appearances and developmental patterns.
  • Lacunae formation is linked to uterine scarring and a high probability of placenta accreta spectrum.
  • Further understanding of sonolucent spaces is crucial for identifying high-risk pregnancies and optimizing management.