Differential Diagnosis of the Placental Adhesive Disorders
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چکیده
The adhesion disorders of the placenta such as placenta accreta and percreta, constitute one of the principal causes of maternal morbidity due to hemorrhage post birth. The placenta previa and the reiterative cesarean are the principal risk factors; in them it is possible to diagnose according to direct and indirect echographic signs. However, in certain occasions the information obtained by the ultrasound is not conclusive, particularly in the differentiation between the placenta accreta and percreta. In these cases, or in those in which additional anatomical information is wanted on the placental invasion, the vascularization or on the actual state of the uterine and vesicle wall, the Nuclear Magnetic Resonance (MRI) provides precise anatomic images. These can be contrasted with gadolinium and distinguish exact limits between the miometrium and the placenta. Thus, the surgery and the proximal vascular control can be planned correctly and adequately. The experience with contrasted MRI in 15 risk patients, the distinctive characteristic of the differential images and the surgical correlation are described in this paper.
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Hemoperitoneum Caused by Placenta Percreta in the Third Trimester of Pregnancy
The placental adhesive disorders such as placenta accreta and placenta percreta are the rare causes of serious obstetric hemorrhages. They are associated with high maternal morbidity and mortality. Placenta percreta is usually diagnosed in the third trimester of pregnancy as a massive postpartum hemorrhage when an attempt to remove the placenta reveals lack of a cleavage plane. Here we report a...
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