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Reproductive/Endocrine Imaging

E2698. Developmental Problems of the Placenta

Cherian A,  Holder J. State University of New York Downstate Medical Center, Brooklyn, NY

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Background Information: Placenta previa and its associated abnormalities of vasa previa, placenta accreta, and placental abruption carry significant risks to both mother and fetus. Radiology, specifically ultrasound and MRI, has a significant role in helping guide clinicians to the management of patients with these problems. This presentation will focus on helping radiology residents distinguish each entity and interpret subtle findings that can potentially save the lives of both mother and child.

Educational Goals/Teaching Points: The goals of this exhibit are to review the normal development and anatomic changes involved in placental position and growth during pregnancy and describe and demonstrate findings seen in abnormal placental attachment, position, and growth on ultrasound and MRI. We will also discuss and demonstrate the diagnostic pitfalls involved with tracking placental development throughout pregnancy.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques: This exhibit will provide a review of the normal progression of placental position and growth and cervix length and give examples of their classic appearance on various imaging modalities. Animations will be used to discuss the pathophysiology behind derangements in these processes. MRI and sonographic correlates will demonstrate the subtle and most critical findings associated with these various entities. Common diagnostic difficulties in monitoring placental development during pregnancy and techniques to combat these challenges will also be discussed.

Conclusion: Many imaging findings associated with various placental pathologies can often be subtle and dynamic throughout the pregnancy. Through the various imaging cases and animations, residents should gain an understanding of the normal appearance of the placenta and recognize any derangements in its development. By combining this knowledge with patient history and clinical examination, more women who are high risk can be identified and properly managed to avoid the potentially catastrophic outcomes associated with these problems.