Placenta accreta

Case contributed by Dr Muhammad Yousaf

Presentation

30 years old female presented for an obstetrical scan. She had a previous history of two cesarian sections.

Patient Data

Age: 30 years
Gender: Female

A longitudinal ultrasound scan shows an anteriorly lying placenta completely covering the internal OS. There is a loss of clear retroplacental space near the scar site. Further, lacunes extend into the uterus-bladder interface and show abnormal color filling.

Above mentioned findings were likely suggestive of the adherent placenta.

MRI was performed for further evaluation.

Placental thickness is increased in the lower uterine segment along with internal heterogeneity more in the lower segment. Anteriorly, the T2 hypointense band is lost, and the myometrium appears thinned out. Few thick signal voids are noted crossing the placental myometrial interface at right angle extending up to dome of urinary bladder.

Multiple small gallstones and physiological right hydronephrosis are also noted.

Case Discussion

This case shows ultrasound and MRI findings of the placenta accreta spectrum.

Ultrasound is the initial modality of choice to rule out the adherent placenta.

MRI can further be used in equivocal cases.

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