CASE 586: PLACENTA ACCRETA or not, Dr PHAN THANH HẢI, Dr JASMINE THANH XUÂN, Dr VÕ HIẾU THÀNH, Dr THÙY MAI, MEDIC MEDICAL CENTER, HCMC,VIETNAM.

Female 25 yo, PARA  0020,  with 01 surgery for extrauterine pregnancy,  now suspected placenta accreta in 37,5 weeks of pregnancy by ultrasound in Hung vuong hospital.

Ultrasound and MRI in Medic= placental accreta in small part in left angle of uterine fundus.

Ultrasound showed a thin part of uterus with a poor placenta part nearby that made thinking about placenta accreta.

MRI= It is difficult to see muscular layer of left side of uterine fundus that may be invaded abnormally by placenta accreta.

Finally, results of cesarean surgery shows a normal placenta.

Discussion= Wrong thinkings of ultrasound due to abnormal of uterus post op: at the site of the late surgery,  the poor echogeneicity of  part of placenta made thinking about placenta accreta. However, it exists non Doppler signal at this site, so nothing proved for an evident of placenta accreta. 

Nota= 

There were some ultrasound findings of placeta accreta=

 - vascular lacunae  in small and large size in placenta with hypervascular and   turbulent flows

 - loss of hypoechoic line in posterior of placenta

 - abnormal of wall of bladder due to invasion by placenta