Placenta previa and accreta

Case contributed by Dr Bahman Rasuli

Presentation

G4 P3+1 pregnant lady GA 30 weeks with a history of 3 prior Cesarian sections referred with placenta previa for further evaluation.

Patient Data

Age: 30 years
Gender: Female

The placenta is covering the internal os (placenta previa ).

The focal indistinctness of the uterine myometrium hypointense line with a dark T2 intraplacental band noted at the lower uterine segment with mild placental heterogeneity.

 Mild focal uterine bulge with bladder indentation also is noted.

Case Discussion

Placenta accreta was confirmed at surgery and hysterectomy was done.

Placenta accreta is a life-threatening condition mostly related to deficient decidua at the cesarean section site.  Previous cesarean sections and placenta previa are the two most important predisposing factors.

In this case, the presence of dark T2 intraplacental bands extending within the placenta from the placenta–myometrium interface, heterogeneity of the placenta, the focal indistinctness of the myometrial wall and focal uterine bulging are the manifestations of placenta previa and accreta.

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