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This review covers ultrasound evaluation of the normal and abnormal placenta with clinical correlation. Normal placental function is essential for a healthy pregnancy outcome as well as for maternal, fetal, childhood, and adult health. Abnormal placental function may result in a compromised pregnancy, creating pathology for the fetus and mother alike. Despite the fact that placental anatomy, function, and location has far-reaching effects for the parents and the developing offspring, ultrasound examination of the placenta is often considered secondary to the fetus by expectant parents and sonographers as well. Location, size, shape, and architecture are easily ascertained with two-dimensional techniques. Three-dimensional ultrasound and Doppler techniques have opened up the frontier of placental function and have set the stage to make placental evaluation as fascinating as that of the fetus. Learning objectives To assess normal placenta by ultrasound. To discuss abnormal placenta and umbilical cord. To understand placentation in multiple gestation.

A 60-year-old female patient, with no notable medical history, was referred by the internal medicine department for a dry mouth workup. The clinical examination revealed an absence of dryness, and the presence of lingual fasciculations, associated with difficulties in mastication and phonation. These symptoms appeared spontaneously 9 months before the consultation, after leaving confinement. Given the presence of lingual fasciculations, the diagnostic hypothesis of a neurological pathology, in particular amyotrophic lateral sclerosis (ALS), was suspected. After performing an electromyogram (EMG), the diagnosis of ALS was retained. Riluzole treatment was then started, and physical therapy sessions were scheduled. Riluzole allows an average gain of 4 to 6 months of life expectancy. Speech therapy and physical therapy allow to maintain the functions as long as possible and to improve the end-of-life conditions. The interest of early detection of ALS allows delaying the progression of the disease.