placenta accreta investigation

2. Indication for investigation
Prior uterine surgery or instrumentation
 placenta Previa
Advanced maternal age
Grand multipara
IVF

3. Methods of diagnosis
 Ultrasound
 Trans vaginal US
 Trans abdominal US
 MRI
 Diagnosis typical occur in 2nd & 3rd trimester, but may also be possible in
the 1st trimester

4. Normal Image of placenta

5. Placenta accrete
Low implantation
Placenta lakes
Myometrial thinning
Interrupted serosa
Color Doppler

6. Low implantation
 Placenta accrete is suggested in the first
trimester

7. Placenta lakes
Mouth eaten appearance

8. Myometrial thinning

9. Interrupted serosa

10. Dilated vascular channels

11. Hyper vascularity linking placenta to bladder

12. MRI
 Uterine bulging
 Heterogeneous placenta
 Thinning and interruption
of myometrium
 Obliteration of normal tissue
planes
 Dark intraplacental bands

13. 1-Heterogeneous placenta with
lacunae.
2-Placenta bulges into upper
bladder surface

14. Dark intraplacental bands

15. Thinning and interruption of myometrium