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Prenatal diagnosis of morbidly adherent placenta using gray-scale, color doppler, three-dimensional power doppler ultrasound, and magnetic resonance imaging – A case report

Paulette A. Maquiran-Tambalo, MD, FPOGS and Anita Matilda F. Poblete, MD, FPOGS, FPSUOG, FPSMFM
Department of Obstetrics and Gynecology, Cardinal Santos Medical Center

Background: Morbidly adherent placenta (MAP) refers to a spectrum of conditions characterized by abnormal adherence of the placenta to the implantation site. It is usually associated with peripartum hysterectomies, excessive blood loss, and bladder and bowel injuries. Reliable antenatal diagnosis of MAP is needed as unexpected encounter with such condition can lead to catastrophic outcomes. It allows the pre-operative assembly of a multidisciplinary team in the surgical management of such cases, an approach which has been shown to improve maternal and fetal outcomes.

Case summary: A case of a morbidly adherent placenta diagnosed antenatally using gray-scale, Color Doppler, 3-Dimensional power Doppler ultrasound and Magnetic Resonance Imaging is reported. A multidisciplinary team consisting of OB - GYN ultrasonologist, radiologist, maternal fetal medicine specialist, gynecologic oncologist, anesthesiologist, neonatologist, internist, urologic-oncologist, vascular and general surgeons, was used to manage the case. Favorable maternal and fetal outcomes resulted from the use of this team.

Conclusion: Prenatal diagnosis of MAP with gray-scale, Color Doppler, 3-Dimensional power Doppler ultrasound and Magnetic Resonance Imaging and the use of standardized imaging descriptors for AIP allowed the development of a multidisciplinary care team approach during delivery which provided a safe outcome for both mother and baby.

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