The key ultrasound findings that suggest a diagnosis of placenta accreta spectrum (PAS) in a pregnant patient include several characteristic features.
One significant finding is the loss of the clear retroplacental zone or space Jauniaux & Bhide 2017Horgan & Abuhamad 2022. The presence of multiple placental lacunae, which are irregular vascular spaces within the placenta, is another strong indicator Jauniaux & Bhide 2017Horgan & Abuhamad 2022. Additionally, ultrasound may reveal thinning, disruption, or irregularity of the myometrial-bladder interface or uterine serosa-bladder interface Jauniaux & Bhide 2017Horgan & Abuhamad 2022. Increased vascularity at the myometrial-bladder interface is also a suggestive sign Jauniaux & Bhide 2017Horgan & Abuhamad 2022. The visualization of bridging vessels, which extend from the placenta into the myometrium or beyond, further supports a diagnosis of PAS Jauniaux & Bhide 2017Horgan & Abuhamad 2022. On color Doppler, turbulent blood flow within the lacunae can also be observed Horgan & Abuhamad 2022.
Key References
- NG192 - Caesarean birth
- NG126 - Ectopic pregnancy and miscarriage: diagnosis and initial management
- CKS - Pregnancy (uncomplicated) - antenatal care
- CKS - Antenatal care - uncomplicated pregnancy
- CKS - Hypertension in pregnancy
- CKS - Ectopic pregnancy
- (Jauniaux and Bhide, 2017): Prenatal ultrasound diagnosis and outcome of placenta previa accreta after cesarean delivery: a systematic review and meta-analysis.
- (Society of Gynecologic Oncology et al., 2018): Placenta Accreta Spectrum.
- (Horgan and Abuhamad, 2022): Placenta Accreta Spectrum: Prenatal Diagnosis and Management.