E5252. A Review of Placental and Umbilical Cord Diseases and Variants
Authors
Samuel Beaujean;
Mather Hospital - Northwell Health
Aakash Babaria;
Mather Hospital - Northwell Health
Background
The placenta plays a vital role as the interface between maternal and fetal circulation. Despite its importance, the placenta can sometimes be overlooked in routine obstetric imaging evaluation. If not identified expeditiously, placental pathology can significantly impact maternal and fetal morbidity and mortality.
Educational Goals / Teaching Points
The primary goal of this presentation is to provide a systematic approach to identifying and differentiating between different disorders and variants of the placenta and umbilical cord using a case-based format. Normal appearance and expected evolution of the placenta as seen on ultrasound and MRI will be reviewed and MRI protocols and sequences crucial for placental imaging will be discussed. Special emphasis will be given to true pathology of the placenta, normal variants, and potential pitfalls of misinterpretation.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Placental and placental-associated abnormalities will be discussed in the context of six major categories including umbilical cord anomalies, placental masses, placental adherence disorders, placenta previa, retained products of conception, and hemorrhage. For each disease process, the clinical features, associated imaging findings, and differential diagnoses will be outlined. Ultrasound will be the primary modality discussed, with mention of circumstances when MRI or possibly CT may be warranted. Imaging examples will be accompanied by illustrations to enhance conceptualization and understanding. In addition, placental morphologic variants, potential interpretation pitfalls, benign incidental lesions, and twin pregnancies will be reviewed to complete the discussion.
Conclusion
Although rare, placental abnormalities can significantly impact the outcome of a pregnancy as well as have long-term negative effects on maternal health. It is imperative that radiologists who routinely interpret obstetric imaging studies adopt a systematic approach in excluding placental pathology. Efficient recognition of placental disease on imaging can allow for timely notification of referring clinicians who can then initiate a prompt and appropriate treatment plan.
