Podcast
Questions and Answers
What is the term for a placenta that protrudes through the uterine serosa?
What is the term for a placenta that protrudes through the uterine serosa?
Which of the following is NOT a risk factor for placenta accreta?
Which of the following is NOT a risk factor for placenta accreta?
What is the significance of the loss of the normal hypoechoic retroplacental-myometrial interface on sonography?
What is the significance of the loss of the normal hypoechoic retroplacental-myometrial interface on sonography?
What is the characteristic of the blood flow in placenta increta or placenta percreta on color Doppler ultrasound?
What is the characteristic of the blood flow in placenta increta or placenta percreta on color Doppler ultrasound?
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What is the term for a placenta that is abnormally adherent to the uterine wall after delivery?
What is the term for a placenta that is abnormally adherent to the uterine wall after delivery?
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What is the significance of the presence of focal exophytic masses on sonography?
What is the significance of the presence of focal exophytic masses on sonography?
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What is the characteristic of placental lakes on sonography?
What is the characteristic of placental lakes on sonography?
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What is the term for a placenta that invades the myometrium more deeply?
What is the term for a placenta that invades the myometrium more deeply?
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What is the significance of the demonstration of vessels crossing the placental-myometrial disruption site on color Doppler ultrasound?
What is the significance of the demonstration of vessels crossing the placental-myometrial disruption site on color Doppler ultrasound?
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What is the significance of the absence of the normal subplacental venous flow on color Doppler ultrasound?
What is the significance of the absence of the normal subplacental venous flow on color Doppler ultrasound?
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Study Notes
Placenta Anomalies
- Placenta accreta: a placenta that is abnormally adherent to the uterine wall after delivery
- Placenta increta: a placenta that invades the myometrium more deeply than accreta
- Placenta percreta: a placenta that protrudes through the uterine serosa, at least in part
Risk Factors for Placenta Accreta
- Prior uterine surgery, with increasing risk with increasing number of prior cesarean deliveries
- Placenta previa
- Unexplained elevated maternal serum alpha-fetoprotein (MS-AFP)
- Increased maternal cell-free placental lactogen
- Advancing maternal age
Characteristics of Placenta Accreta
- Presence of a coexisting placenta previa in the majority of cases
- The adherent portion of the placenta is often low in the uterus, in the region of a prior cesarean scar
Sonographic Findings of Placenta Accreta
- Loss of the normal hypoechoic retroplacental-myometrial interface
- Thinning or disruption of the hyperechoic subvesicular uterine myometrium/serosa
- Presence of focal exophytic masses
- Numerous placental lakes
Color Doppler Ultrasound Findings
- Diffuse lacunar blood flow throughout the placenta
- Dilated vascular channels between the placenta and bladder or cervix
- Absence of the normal subplacental venous flow
- Demonstration of vessels crossing the placental-myometrial disruption site
Characteristics of Placenta Increta or Percreta
- Greatly increased vascular lacunae with turbulent or “tornado” blood flow
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Description
This quiz covers placenta abnormalities, including placenta accreta, increta, and percreta, and their risk factors, such as prior uterine surgery and placenta previa.
