22 feb. 2011 USE OF ULTRASOUND FOR INVASIVE PLACENTATION DIAGNOSIS
Anca A. Simionescu
Universitatea de Medicina si Farmacie Carol Davila , Spitalul Clinic Filantropia
Rezumat: Utilizarea ecografiei în diagnosticul placntatiei invazive
Invazia anormala placentara poate determina complicatii redutabile la nastere, depistarea ei ecografica prenatala va determina masuri preventive si planificarea nasterii in centre cu dotarea tehnica si umana necesare. Prezentam experienta personala a utilizarii ecografiei pentru diagnosticarea insertiei placentare invazive cu ocazia ecografiilor de screening prenatal. Din cele 564 ecografii consecutive efectuate la paciente ale caror informatii pre- si postantale au fost cunoscute, s-au analizat doua cazuri la care suspiciunea ecografica de placenta percreta si accreta a fost confirmata anatomo-patologic , pe piesele de histerectomie de necesitate. In concluzie, examinarea atenta ecografica a placentei si descrierea acesteia , ca si precizarea semnelor imagistice sugestive pot contribui la efectuarea prenatala a diagnosticului si la pregatirea corespunzatoare a nasterii , cu scaderea mortalitatii si morbiditatii materne.
Abstract
Abnormal invasive placentation has become an important factor of maternal complication; prenatal diagnosis by ultrasound may help to prevent complications, and to organise the delivery in a hospital with Surgical operating and Intensive Care Departments. Herein we present a descriptive analysis of 564 consecutive ultrasounds performed routinely for prenatal diagnosis ; two cases of placenta percreta and accreta were identified retrospectively, and echografic signs and confirmation by anatomopathology examination after Cesarean hysterectomy were reported.In conclusion, the carreful ultrasound examination of the placenta and the descriptive analysis of different ultrasound markers for placenta accreta , percreta, increta , may improve the detection of invasive placentation and contribute to the best management of delivery, in order to reduce maternal mortality and morbidity.
Keywords: sarcină, ecografie, palcenta acreta, percreta, increta