Department of Gynecology and Obstetrics, Army Medical University, ChinaFulltext PDF
Introduction: Pre-operative ultrasound assessment of placental margin position and severity of placental implantation, position of umbilical cord insertion, and guidance of uterine incision selection before operation based on anatomical markers on the body surface of pregnant women with complete placenta, thereby reducing severe blood loss during delivery and lowering postpartum hemorrhage. Case Presentation: Pregnant woman, 27 years old, 37 weeks gestation, G5P1. Color Doppler tips: Complete type of placenta previa, placenta completely covers the anterior wall of the uterus and the inner cervix, part of the posterior wall and side wall. The placenta boundary with the muscle wall of the lower uterus is unclear at 32 mm below the umbilicus. The implantation area is 42 mm × 36 mm. MRI Results: • Complete placenta previa. • The boundary between the lower part of the anterior wall of the uterus is unclear, and placental implantation is possible. Conclusion: For the complete placenta previa in the third trimester, the placenta is widely attached to the anterior wall of the uterus with partial implantation of the uterine incision. The placenta cannot be avoided to deliver the fetus. Ultrasound "three-line four-zone method" accurately locates the placental edge and the umbilical pedicle. Selecting an appropriate incision in the uterus can reduce bleeding during the operation and acute fetal blood loss, and the incidence of maternal and infant complications.
Luo W, Chang Q, Wang D, Yan X. Preoperative Ultrasound Positioning Uterine Incision of Complete Placenta Previa to Reduce Maternal and Infant Complications in the Third Trimester. Ann Clin Case Rep. 2020; 5: 1815.