Journal of Ultrasound in Medicine, Vol 11, Issue 1 29-34, Copyright © 1992 by American Institute of Ultrasound in Medicine
Placenta accreta. Additional sonographic observations
J. C. Hoffman-Tretin, M. Koenigsberg, A. Rabin and A. Anyaegbunam
Department of Radiology (Division of Ultrasound), Bronx Municipal Hospital Center, New York.
Recent reports describe the antenatal sonographic diagnosis of placenta
accreta based on failure to visualize a hypoechoic zone at the placental
margin. This finding was confirmed in our series of seven cases. New
observations in this series include prominent large or multiple placental
venous lakes and periuterine vascularity in six of seven cases, and
progressive thinning and disappearance of the retroplacental hypoechoic
zone on sequential examinations in two of seven cases. Loss of normal
venous flow pattern on Doppler interrogation of the peripheral placental
margin also appeared to be of value in two patients. Histologic correlates
for these findings are suggested on the basis of the primary
histopathologic feature of placenta accreta: deficiency of the decidua
basalis. Differential diagnostic considerations, including abdominal
pregnancy and trophoblastic disease, also are discussed.
