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© 2003 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 22:19-23 • 0278-4297

The Early Sonographic Appearance of Placenta Accreta

Christine H. Comstock, MD, Wesley Lee, MD, Ivana M. Vettraino, MD and Richard A. Bronsteen, MD

Division of Fetal Imaging, Department of Obstetrics and Gynecology, William Beaumont Hospital, Royal Oak, Michigan USA.

Address correspondence and reprint requests to Christine H. Comstock, MD, Division of Fetal Imaging, Department of Obstetrics and Gynecology, William Beaumont Hospital, 1375 W Thirteen Mile Rd, Royal Oak, MI 48073 USA.

Objective. To determine whether any sonographic findings in the first trimester predict placenta accreta. Methods. Patients who had a diagnosis of placenta accreta, increta, or percreta by clinical course or pathologic examination of the uterus and who had had a sonographic examination at 10 weeks or earlier were included in this study. Results. Seven patients met the study criteria. In 6 of these, who had had at least 1 previous cesarean delivery, the gestational sac was located in the lower uterine segment at the time of the early scan. Two of these pregnancies failed shortly after the early scan, and the patients underwent dilation and curettage, at which time severe bleeding necessitated a hysterectomy. The other 4 continued to term but had sonographic findings typical of placenta accreta during subsequent scans. In the seventh patient (who had had no previous cesarean deliveries), the gestational sac was located in the uterine fundus. Conclusions. In a patient with a previous cesarean delivery, a sac lying in the lower uterine segment on a scan at 10 weeks or earlier suggests the possibility of placenta accreta.

Key Words: cesarean delivery • first trimester • gestational sac location • placenta accreta • pregnancy

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Copyright © 2003 by the American Institute of Ultrasound in Medicine.