Background: placental abruption is usually an acute event in which clinical decision-making overrides the need for ultrasound imaging. By contrast, chronic abruption may present with vague or even confusing clinical findings. We describe a case in which the diagnosis of chronic abruption was established by ultrasound and the findings directly influenced clinical care.
Case: a 30-year-old woman with asymptomatic preeclampsia was evaluated in our fetal medicine unit at 30 weeks' gestation. Despite normal fetal monitoring, a large, retroplacental sonolucent area was noted on ultrasound. A planned Caesarean section was performed two days later, despite normal daily fetal monitoring, because the mass had increased in size. Placental pathology confirmed the diagnosis of chronic abruption.
Conclusion: ultrasound may establish the diagnosis of a large chronic placental abruption that is relevant for clinical management.