Images of some of the causes of APH
Image 1 - Vasa praevia
In image 1 uprotected fetal vessels can be seen running from the leading edge of the anterior placenta to the posterior uterus near the cervix, however, it is not common to see on ultrasound imaging
Image 3 - Placenta praevia
In image 3 a low lying anterior placenta can be seen, the fetal head is seen above the placenta
The longer arrow points to the low lying placenta and small arrow identifies the placenta overlying the cervix
Image 2 - Vasa praevia
It is more usual to be suspected following rupture of membranes wirh subsequent fetal distress and fetal vessels identified at delivery of the placenta when they can be seen running through the membranes as shown in image 2
Image 4 - Placenta accreta
In image 4 the arrows in this ultrasound image show loss of demarcation between placenta and uterus
This would usually be a smooth plane but it is difficult to distinguish between the two here and placenta accreta is suspected
Colour flow doppler may add to this by showing increased flow
MRI may be requested in cases of suspected accreta to help further determine what is going on to allow a management plan to be formulated but is not always superior to ultrasound
