Winner of CoW 24 July 2016
Placenta previa
Findings
Placenta completely covers the internal cervical os with an early subacute subchorionic hematoma showing diffusion restriction & blooming Imp:complete placenta previa with early subacute subchorionic hematoma.
Discussion
Placenta previa: Placenta implants in the lower uterine segment Placenta crosses or lies close to the internal os of cervix Location: Complete- placenta completely covers the internal os Partial-placenta partially covers the internal os Marginal-placenta reaches the margin of internal os but doesnot cover it Low lying-placental edge within 2 cm from internal os Usg: Due to placental trophotropism the diagnosis of placenta previa is not usually made before 20 weeks During routine 18 weeks scan,the distance between lower edge of placenta &internal os should be measured If it lies within a few cms of the os,then repeat scan at 32 weeks should be performed to ensure the edge has migrated further away Mri: Gold standard in imaging of placenta and its relationship to the cervix Sagittal T2 images best demonstrates the relationship of the placenta to the internal cervical os On T1 weighted spin echo imaging,placental tissue has low signal & slightly higher than that of myometrium On T2 weighted spin echo imaging,placental tissue has high signal intensity & is clearly distinguishable from the adjacent fetus ,uterus & cervix.
Findings
Placenta completely covers the internal cervical os with an early subacute subchorionic hematoma showing diffusion restriction & blooming Imp:complete placenta previa with early subacute subchorionic hematoma.
Discussion
Placenta previa: Placenta implants in the lower uterine segment Placenta crosses or lies close to the internal os of cervix Location: Complete- placenta completely covers the internal os Partial-placenta partially covers the internal os Marginal-placenta reaches the margin of internal os but doesnot cover it Low lying-placental edge within 2 cm from internal os Usg: Due to placental trophotropism the diagnosis of placenta previa is not usually made before 20 weeks During routine 18 weeks scan,the distance between lower edge of placenta &internal os should be measured If it lies within a few cms of the os,then repeat scan at 32 weeks should be performed to ensure the edge has migrated further away Mri: Gold standard in imaging of placenta and its relationship to the cervix Sagittal T2 images best demonstrates the relationship of the placenta to the internal cervical os On T1 weighted spin echo imaging,placental tissue has low signal & slightly higher than that of myometrium On T2 weighted spin echo imaging,placental tissue has high signal intensity & is clearly distinguishable from the adjacent fetus ,uterus & cervix.
Note:
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!