Management and surgery of abnormal invasive placenta: Impact of MR imaging

Abnormal invasive placenta describes a group of conditions that produce the abnormal infiltration of placental tissue into the uterus or also into the surrounding tissues. This condition usually produces severe complications for the mother, such as massive haemorrhage, organ damage, organ failure and even death [1]. Within the term “accreta”, different degrees of placental invasion are involved, named as placenta increta and percreta according to a histological classification, but they were also described as a group clinically termed abnormal invasive placenta [2, 3] (AIP). Increasing rates of caesarean are an emergent problem worldwide, and they are related to the exponential risk from AIP. Ultrasound and Doppler are regarded as excellent tools to perform a diagnosis in these cases [4, 5]. Although diagnostic accuracy in all methods is operator dependent, this problem is particularly important in ultrasound studies because image acquisition is personally guided by the operator. Recently, this question has been analysed in some papers and also the necessity to create an international consensus to establish the most accurate value to the diagnostic signs [6].