Formaţiuni placentare decelabile ecografic: motiv de îngrijorare?

With the development of ultrasonography, many placental lesions have become detectable since the first trimester of pregnancy. Some of the most common placental lesions diagnosed by ultrasound are hypoechoic images, causing controversy over differential diagnosis and possible damage to the fetus. Placental lakes are anechoic lesions with a diameter ≥1 cm surrounded by placental tissue with normal echogenicity, being frequently diagnosed in the second trimester of pregnancy. Their incidence varies between 2.2% and 17.8%, usually without impact on fetal development. Subchorionic cysts are anechoic lesions, without Doppler signal, that can be detected from the first trimester. Their content differs from amniotic fluid and histologically there are detected perivillous fibrin desposits and X cells. The association with intrauterine growth restriction (IUGR) assumes: cyst count >3, diameter >4.5 cm or their location near the placental cord insertion site (PCIS). Echogenic cystic lesions (ECL) are hypoechoic lesions ≥1 cm in diameter, characterized by an echogenic crown and an irregular border. They may be correlated with IUGR and preeclampsia, histologically identifying predominantly as inter-villous thrombi. Other possible differential diagnoses should be considered: chorioangiomas, hydatiform moles, placenta accreta, and "vanishing twin". In conclusion, a wide range of placental lesions can be detected by ultrasound, with a variable echo over the development of the fetus. The antenatal diagnosis of these entities is of particular importance. [ABSTRACT FROM AUTHOR]