Ultrasound and MRI are used to diagnose placenta accreta, which occurs when the placenta invades the uterine wall due to prior uterine surgery or other risk factors. On ultrasound, signs include low placental implantation, lakes or indentations in the placenta, thinning of the myometrium, disruption of the uterine serosa, and abnormal blood flow on Doppler. MRI may show uterine bulging, a heterogeneous placenta, thinning and interruptions of the myometrium, obliteration of tissue planes, and dark bands within the placenta. These imaging findings help identify placenta accreta and guide management of delivery.

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