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Journal of Ultrasound in Medicine, Vol 11, Issue 7 333-343, Copyright © 1992 by American Institute of Ultrasound in Medicine
Placenta accreta: prospective sonographic diagnosis in patients with placenta previa and prior cesarean section
H. J. Finberg and J. W. Williams
Phoenix Perinatal Associates, AZ 85006.
A prospective evaluation for possible placenta accreta was performed in 34
patients with placenta previa and a history of one or more cesarean
sections. Sonographic criteria used included (1) loss of the normal
hypoechoic retroplacental myometrial zone, (2) thinning or disruption of
the hyperechoic uterine serosa-bladder interface, and (3) presence of focal
exophytic masses. Of 18 patients with positive sonographic results, 14 had
proof of placenta accreta and 16 of the patients underwent hysterectomy. Of
16 patients with negative sonographic results, only one had placenta
accreta, and two patients required hysterectomy. Presence of numerous
intraplacental vascular lacunae appears to be an additional risk criterion
for placenta accreta, separate from the other criteria listed above.
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