Placenta acrreta spectrum-first trimester, 2D and 3D ultrasound, and magnetic resonance imaging findings

J Clin Ultrasound. 2024 Mar-Apr;52(3):321-330. doi: 10.1002/jcu.23627. Epub 2023 Dec 21.

Abstract

Background: The term placenta accreta spectrum (PAS) is commonly used to describe abnormal trophoblastic invasion of the myometrium, serosa, or organs adjacent to the uterus. It is of great obstetric importance because of its high morbidity, risk of hemorrhage, admission to the intensive care unit, risk of hysterectomy, and high risk of iatrogenic pelvic lesions and even death. These risks are minimized when prenatal diagnosis is performed. Prenatal diagnosis of PAS is based on imaging findings suggestive of abnormal and pathologically adherent placentation, including placental lacunae (intraplacental sonolucent spaces), disruption of the bladder-uterine serosa interface, turbulent flow on color Doppler, and bridging vessels.

Objective: In this article, we review the major prenatal imaging features of PAS using diagnostic modalities (first trimester, two-dimensional ultrasound, three-dimensional ultrasound, and magnetic resonance imaging) for the diagnosis of PAS.

Keywords: first trimester of pregnancy; magnetic resonance imaging; placental accreta spectrum; three-dimensional ultrasound; two-dimensional ultrasound.

Publication types

  • Review

MeSH terms

  • Female
  • Humans
  • Magnetic Resonance Imaging / methods
  • Placenta / pathology
  • Placenta Accreta* / diagnostic imaging
  • Placenta Diseases*
  • Placenta Previa*
  • Pregnancy
  • Pregnancy Trimester, First
  • Retrospective Studies
  • Ultrasonography, Prenatal / methods