PDF(Pubmed)
Abstract：
Accurate prenatal discrimination between a simple, non-adherent uterine scar dehiscence with an underlying placenta and the severe end of the placenta accreta spectrum is problematic as the two can appear similar on prenatal imaging. This may lead to the false diagnosis of placenta accreta spectrum resulting obstetric anxiety, overtreatment and potential iatrogenic morbidity. Despite potential similarities in the etiology, the manifestation and management of these two conditions is very different. The prenatal sonographic features of seven confirmed cases of simple uterine scar dehiscence with an underlying placenta previa were examined. The common sonographic features found for scar dehiscence was a thinned myometrium (<1 mm) overlying a generally homogenous placenta and a placental bulge. There was absence of lacunae and features of hypervascularity including bridging vessels. Our findings suggest accurate discrimination between a simple scar dehiscence with the placenta underlying it and placenta accreta spectrum can be made on prenatal ultrasound if the placenta is carefully examined for the vascular features unique to PAS.
摘要：
精确的产前歧视之间的简单，非粘附性子宫瘢痕裂开并带有下方胎盘和胎盘植入谱的严重末端是有问题的，因为这两者在产前成像中可能看起来相似。这可能会导致胎盘植入谱的误诊导致产科焦虑，过度治疗和潜在的医源性发病率。尽管病因有潜在的相似性，这两种情况的表现和管理是非常不同的。检查了7例确诊的单纯性子宫瘢痕裂开伴潜在前置胎盘的产前超声特征。瘢痕裂开的常见超声特征是子宫肌层变薄（<1mm），覆盖通常均匀的胎盘和胎盘凸起。没有腔隙和包括桥接血管在内的高血管特征。我们的发现表明，如果仔细检查胎盘的PAS特有的血管特征，则可以在产前超声检查中准确区分胎盘下方的简单疤痕裂开和胎盘植入频谱。
