Placenta previa increta diagnosed at 18 weeks' gestation. Report of a case with sonographic and pathologic correlation.

BACKGROUND

Placenta previa incerta, although uncommon, assumes considerable clinical significance because of the morbidity associated with severe hemorrhage, uterine perforation and infection. The majority of cases are unanticipated and initially identified intraoperatively.

CASE: Placenta accreta was diagnosed sonographically at 18 weeks' gestation in a multipara who had previously undergone cesarean delivery. Additionally, the gestation was complicated by chronic renal failure secondary to systemic lupus erythematosus. After appropriate counseling, total abdominal hysterectomy was performed prior to fetal viability.

CONCLUSION

Early sonographic evaluation of the placenta is recommended for those at significant risk of invasive placentation. Timely detection facilitates proper preparation and should reduce maternal morbidity.