Antenatal diagnosis of placenta accreta: a review
Article first published online: 22 JUN 2005
Copyright © 2005 ISUOG. Published by John Wiley & Sons, Ltd.
Ultrasound in Obstetrics & Gynecology
Volume 26, Issue 1, pages 89–96, July 2005
How to Cite
Comstock, C. H. (2005), Antenatal diagnosis of placenta accreta: a review. Ultrasound Obstet Gynecol, 26: 89–96. doi: 10.1002/uog.1926
- Issue published online: 22 JUN 2005
- Article first published online: 22 JUN 2005
- Manuscript Accepted: 25 APR 2005
- magnetic resonance imaging;
The incidence of placenta accreta should rise steadily over the next century as the frequency of Cesarean sections and advanced maternal age, both independent risk factors, increases. Patients who are at risk should be identified before an ultrasound examination and the characteristic findings searched for. In the first trimester, these include a low-lying sac that appears to be attached to the anterior wall of the uterus. As early as 16 weeks irregular vascular sinuses appear, which have turbulent flow within. The bladder wall may appear interrupted or have small bulges of the placenta into the bladder space. Absence of the normal echolucent space between the placenta and myometrium is not a reliable sign by itself, since this space may be absent in normal patients with an anterior placenta. Color Doppler will show that some of the placental sinuses traverse the uterine wall. Magnetic resonance imaging has not yet been shown to aid in the diagnosis, but in the future, with improvement of resolution and shortened sequences, it should be particularly useful in identifying the patients that have placenta percreta. Copyright © 2005 ISUOG. Published by John Wiley & Sons, Ltd.