Placental hypoechoic-anechoic areas and infarction: sonographic-pathologic correlation.

Abstract

High-resolution ultrasound (US) and pathologic analysis were used to define the relationship between placental hypoechoic-anechoic areas, frequently seen in the third trimester, and the clinically significant entity of placental infarction. Placentas were obtained from three groups of patients: those prospectively demonstrating one or more placental hypoechoic-anechoic areas greater than or equal to 1 cm in diameter on third-trimester sonograms (n = 14), those with risk factors for vascular disease (n = 12), and control patients without risk factors (n = 16). Pathologic analysis demonstrated significantly more infarcts in patients with risk factors than in control patients (17 vs three, P = .047). Of a total of 22 infarcts from all three groups, 19 (86%) were isoechoic to viable placenta and therefore not detected with US. The three infarcts identified with US contained hypoechoic or anechoic foci of fibrin or hemorrhage. Of 26 placental hypoechoic-anechoic areas 23 (88%) were decidual septal cysts or intervillous thrombosis without infarction. The authors conclude that nonhemorrhagic placental infarction cannot be identified with ex utero US and, by inference, that prenatal US is probably insensitive for detection of placental infarction.

Placental lakes on sonographic examination: Correlation with obstetric outcome and pathologic findings

“…6 In the largest series published, Thompson et al, 9 in an unselected population of 1,198 patients examined at 18-22 weeks of gestation, found a 17.8% rate of placental lakes; no association with poor pregnancy outcome was observed. Harris et al 3 reported that when these lesions are few in number (< 3) and of small diameter (< 2 cm) after 25 weeks' gestation, they may be of no clinical significance. However, when they appear in large numbers ( 3) and are of a larger size ( 2 cm) before 25 weeks' gestation, they may constitute an early warning sign for fetal problems.…”

“…1,2 Anechoic or hypoechoic lesions are the most frequent placental abnormalities on sonograph. 3 The most common terms used to label these anechoic and hypoechoic images are ''lakes'' or ''caverns,'' defined as anechoic areas measuring at least 1 cm in largest diameter and surrounded by normal echogenic placental parenchymal. 4 On pathologic examination, the main findings correlating with this sonographic pattern have been intervillous thrombosis, decidual septal cysts, and infarcts.…”

“…4 On pathologic examination, the main findings correlating with this sonographic pattern have been intervillous thrombosis, decidual septal cysts, and infarcts. [3][4][5] Few studies have evaluated whether placental lakes on sonography are associated with pregnancy outcome. Most studies that have done so have included only a small number of cases and have included cases with maternal or fetal disease.…”

Fetus Disi Degerlendirme: Plasenta, Umbilikal Kord, Amniyon, Serviks

“…Genellikle klinik önemleri yoktur [18]. İlk ya da erken ikinci trimesterde ortaya çıkanlar, çok yaygın olanlar ya da çok büyük boyuta (>4-5 cm) ulaşanlar İUGG, ani fetal ölüm, postpartum kanama nedeni olabilirler [19][20][21]. Eşlik eden fetal ya da maternal hastalık, kalın plasenta, yüksek serum AFP ya da anormal uterin arter Doppler bulgusu olanlarda bu riskler daha fazladır [22].…”

An Unusual Prenatal Ultrasound Image of Placental Lake in High Risk Pregnancy

“…[3][4][5] Today, some studies that have been done provide the connection between size and number of placental lakes with pregnancy outcome. Our case supports the above presented claim.…”