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Placenta Previa | Morbidly Adherent Placenta | Placenta Increta || Ultrasound || Doppler || Case 283
Clinical Features:
A 23 years old female patient came with
- Amenorrhoea for 9 months
- Pervaginal bleeding several times
- Previous history of c/s
Ultrasound Features:
- About 36+ week sized single live intrauterine pregnancy with cephalic presentation & adequate liquor.
- Placenta is anterior with completely covering the cervical internal os.
- Echogenic mass-like area with large, irregular, tornado-shaped lacunar vessels having turbulent flow on Doppler in the placental surface near the previous c/s scar with loss of normal retroplacental hypoechoic ‘clear zone’ & myometrium.
- Intact perimetrium & urinary bladder wall.
Remember:
-Clinically similar & imaging can not differentiate, therefore newer terms used to describe spectrum include:
- Morbidly adherent placentation (MAP)
- Placental adhesive disorders
- Abnormally invasive placenta
-Check the perimetrium as well as the bladder & rectal walls carefully with color Doppler to exclude invasion into those structures.
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