Placenta accreta diagnosed at 9 weeks' gestation

Abstract

The majority of cases of placenta accreta are unanticipated and initially identified intraoperatively. Although color Doppler ultrasound is adequate for the evaluation of placenta accreta in the third trimester, ultrasound diagnosis in the first trimester has never been reported. To our knowledge, this is the first case of placenta accreta detected at 9 weeks' gestation by ultrasound. Placenta accreta with intraplacental lacunae can be identified together with a loss of the hypoechogenic retroplacental myometrial zone. Based on this case, we found that early diagnosis of placenta accreta in the first trimester by ultrasound is possible.

Morbidly Adherent Placenta: A Critical Review

“…According to literature the earliest gestation at which placenta accreta has been diagnosed by ultrasound is 9 weeks in a case of scar pregnancy. The woman continued pregnancy and underwent emergency cesarean hysterectomy at 37 weeks because of placenta increta [11].…”

Placental Sonolucencies in the First Trimester

“…2,3 In contrast to these studies, a prospective study of 1294 cases demonstrated an association with small-for-gestational age infants among 13 patients with large placental sonolucencies (defined as 95 cm in longest diameter) in the second trimester. 6,12 In addition, Cooley et al 13 found that placental sonolucencies in the second trimester were more common among patients who had presented with threatened abortion in the first trimester. 13 Because of the small number of cases of spontaneous abortion in our cohort (4 cases), a clinically useful statistical analysis could not be performed.…”

“…6,10 The incidence of second-and third-trimester placental sonolucencies, defined with varying size and number thresholds, ranges from 2.2% to 17.8%. 1Y3 In this study, it was found that first-trimester placental sonolucencies 0.7 cm or greater were quite common in the general obstetric population, seen in almost 1 in 4 sonographic studies (22.4%).…”

Cas d’une hémorragie grave au cours d’une interruption volontaire de grossesse par aspiration : malformation artérioveineuse ou placenta accreta du premier trimestre ?

“…Néanmoins, Esmans et al ont rapporté le cas d'un placenta percreta responsable d'une rupture utérine à la fin du premier trimestre de la grossesse sur un utérus sain [18]. Pour tous ces cas, le diagnostic a été fait rétrospectivement, à la suite d'hémorragies spontanées ou provoquées, nécessitant dans la plupart des cas une hystérectomie [19][20][21]. L'examen de la pièce opératoire a mis en évidence des agrégats multifocaux de trophoblaste ainsi que des villosités choriales pénétrant le myomètre et pouvant atteindre la séreuse utérine [20].…”