PMC5287996_01
An ultrasound image in greyscale mode. Abdominal probe. Placenta (P) on the anterior wall covers the uterine scar area and overlies the endocervical os. The boundary between myometrium and the placenta is not clear, the deformation of the uterine wall near the bladder (B) is observed. Lacunar spaces (L) of various size and irregular are present in the placenta
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fig1
The sonographic images are presented in Figs. 1-3.
An ultrasound image in Doppler mode. Abdominal probe. Lacunar spaces (L) of various size and irregular are present in the placenta (P). The posterior wall of the bladder (B) is convex. An active heterogeneous blood flow (V) is observed near the bladder and in the placenta
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fig2
The sonographic images are presented in Figs. 1-3.
An ultrasound image in Doppler mode. Transvaginal probe. Lacunar spaces (L) of various size and irregular are present in the placenta (P). The posterior wall of the bladder (B) is convex. An active heterogeneous blood flow (V) is observed near the bladder and in the placenta
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fig3
The sonographic images are presented in Figs. 1-3.
Sagittal T2-weighted MR images. The upper wall of the bladder (B) is locally deformed from the left to 35 mm in length, contact and pressing (arrow) from the side of the placenta (P) is visible, in some places the wall contour of the bladder of the normal signal is clearly differentiated and hypervascular, inadequate myometrium (M)
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fig4
According to the MRI data, it resembles a placenta fused with the bladder, the area of alteration is a hypervascularity with a differentiated relatively large branch of a. iliaca interna sinistra (Figs. 4, 5).
Coronal T2-weighted MR images. The upper wall of the bladder (B) is locally deformed from the left to 35 mm in length, contact and pressing (arrow) from the side of the placenta (P) is visible, in some places the wall contour of the bladder of the normal signal is clearly differentiated and hypervascular, inadequate myometrium (M)
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fig5
According to the MRI data, it resembles a placenta fused with the bladder, the area of alteration is a hypervascularity with a differentiated relatively large branch of a. iliaca interna sinistra (Figs. 4, 5).
A cystoscopy image. Local redness of the bladder mucosa
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fig6
The cystoscopy did not reveal a bladder invasion (Fig. 6).
The uterus with placenta percreta. A longitudinal incision (I) in the corporal area (C). The uterus is deformed due to placenta percreta (P), the walls are thinner and stretched
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fig7
Total hysterectomy without the removal of tubes and ovaries was performed (Fig. 7 - Hysterectomy specimen opened).