Obstetric ultrasound at 30 weeks in a woman with previous caesarean delivery shows multiple large anechoic spaces within the placenta, loss of the retroplacental hypoechoic clear zone overlying the caesarean scar, and bulging of the lower uterine segment contour. Which condition do these features suggest?

• A Placental abruption
• B Succenturiate lobed placenta
• C Placenta accreta spectrum ✓
• D Placental infarction

Explanation

Intraplacental anechoic lacunae, loss of the retroplacental clear zone, myometrial thinning, and uterine serosal bulging over a prior caesarean scar are the hallmark sonographic signs of placenta accreta spectrum. MRI may be added for posterior placentas or equivocal cases. Abruption presents with retroplacental haematoma and pain, while succenturiate lobe is defined by an accessory lobe connected by vessels, none of which match these features.

Reference: Diagnostic Imaging: Obstetrics, 5th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.