New insights in the diagnosis of placenta accreta

Abstract

In this case report we present a patient of 39 weeks pregnancy with a placenta accreta and discuss the new possilities of diagnosis of placental masses with respect to the related literature. The aim of our review was to assess the available useful procedures in an attempt to contribute to the decreasing the morbidity of this condition. Twenty-nine years-old gravida 2, para 0 was referred to our hospital at 38 weeks of gestation for planed delivery by cesarien section. She had a history of prior surgical pregnancy termination at 12 weeks of amenorrhea by dilation and curettage. The abnormal placentation was diagnosed during a routine sonographic examination at 22 weeks of gestation. 2D transvaginal ultrasound showed the total placenta praevia and the presence of multiple intraplacental lacunae. The placenta did not detach with gentle traction,  so placenta accreta was suspected. Heavy bleeding hemorrage from the placental site induced the decision to perform an emergency hysterectomy. The prenatal diagnosis of placenta accreta before delivery allows  multidisciplinary planning and minimize potential maternal or neonatal morbidity and mortality. Grayscale ultrasonography  with the use of color Doppler is sufficient to diagnose placenta accreta. The knowlege of the ultrasound markers for placenta accreta is needed for both radiologist and obstetricians-gynecologist.

Keywords

• Placenta accreta
• placentar lacunae
• turbulent blood flow