| Gray scale and color Doppler sonography in the third stage of labor for early detection of failed placental separation. | |
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MedLine Citation:
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PMID: 10775997 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The purpose of this study was the characterization of normal and abnormal third stage placental separation using gray scale and color Doppler sonography. METHODS: The third stage of labor was examined in 62 patients using gray scale and color Doppler sonography. After identification of placental basal plate vessels by color Doppler sonography, the placentation site was examined throughout the third stage with combined gray scale and color Doppler mode. Placental separation from the myometrium was defined clinically and correlated to cessation of color Doppler detected blood flow in basal plate vessels. RESULTS: Three sonographic phases of placental separation were: (1) latent = interval between delivery of the fetus and beginning placental separation; (2) detachment = mono- or multiphasic shearing off of the placenta and (3) expulsion = interval between completed separation and vaginal delivery of the placenta. In 57 cases with clinically normal placental separation blood flow between placenta and myometrium ceased immediately after delivery of the fetus during the latent period. In five cases manual or instrumental removal was necessary because of placenta adhaerens in one case and placenta accreta in four cases. The latter showed maternal blood flow from the myometrium deep into the placenta beyond the latent phase. CONCLUSION: Cessation of blood flow between the basal placenta and myometrium following delivery of the baby is the sonographic hallmark of normal placental separation. Persistent blood flow demonstrated by color Doppler sonography is suggestive of placenta accreta. |
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Authors:
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M Krapp; A A Baschat; M Hankeln; U Gembruch |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology Volume: 15 ISSN: 0960-7692 ISO Abbreviation: Ultrasound Obstet Gynecol Publication Date: 2000 Feb |
Date Detail:
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Created Date: 2000-05-25 Completed Date: 2000-05-25 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 9108340 Medline TA: Ultrasound Obstet Gynecol Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 138-42 Citation Subset: IM |
Affiliation:
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Department of Obstetrics and Gynecology, Medical University of Lübeck, Germany. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Blood Flow Velocity Delivery, Obstetric / methods Female Humans Labor Stage, Third Myometrium / physiopathology Oxytocics Placenta / physiopathology Placenta Accreta / etiology, physiopathology, ultrasonography* Placenta, Retained / etiology, physiopathology, ultrasonography* Pregnancy Prospective Studies Reproducibility of Results Risk Factors Time Factors Ultrasonography, Doppler, Color / methods* Ultrasonography, Prenatal / methods* |
| Chemical | |
Reg. No./Substance:
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0/Oxytocics |
| Comments/Corrections | |
Comment In:
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Ultrasound Obstet Gynecol. 2000 Feb;15(2):89-95
[PMID:
10775987
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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