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KMID : 0877920110130030097
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Korean Journal of Ultrasound in Obstetrics and Gynocology
2011 Volume.13 No. 3 p.97 ~ p.103
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The Prenatal Sonographic Diagnosis of Placental Adhesion Disorders
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Yang Jeong-In
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Abstract
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Adherent placenta, including placenta accreta and its variants placenta increta, and percreta, refers to placental villi penetrating into the myometrium due to a defect in decidua basalis. It is a major cause of obstetric hemorrhage, which increases the rate of maternal morbidity and mortality with increase of cesarean deliveries. Early diagnosis of adherent placenta before birth is very important in preventing serious obstetric complications such as cesarean hysterectomy and massive transfusion. In at-risk patients the sonographic criteria for adherent placenta include a sac implanted low over an anterior sac, cesarean section scar pregnancy, intraplacental lacunae, and disruption of placental-uterine wall interface at first trimester. During second and third trimesters intraplacental lacunae, loss of clear zone with or not disruption of placental-uterine wall interface, and disruption of the hyperechogenic uterine serosa-bladder interface with or not presence of focal exophytic masses are sonographically detected findings. Of these, intraplacental lacunae is the most reliable image for diagnosis of placenta attachment disorders. Antenatal diagnosis of adherent placenta might be done in patients with placenta previa and previous cesarean section to get better perinatal outcomes.
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KEYWORD
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Adherent placenta, Prenatal diagnosis, Ultrasonography, Intraplacental lacunae
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