Placenta accreta spectrum is a pregnancy condition that is associated with severe morbidity and maternal mortality, particularly when not detected antenatally before adequate treatment is initiated. Women in environments with limited resources are more prone to suffer negative consequences due to practical, technical, and resource deficiencies. Accurate prenatal imaging is an essential step towards achieving positive outcomes because it allows for optimal preparation and care. Despite the fact that the diagnosis can be performed with Bmode (gray-scale) ultrasonography, subsequent reports have emphasized Doppler technology, which is frequently missing from ultrasound equipment used in low-resource settings. The purpose of this article is to describe the many types of placenta lacunae seen during sonography at Moewardi's Hospital in Indonesia. From the year 2016 to 2022, we managed 174 cases of PAS.Placental lakes (circular) were not found during grey scale sonography in three cases, while placental rivers (long, linear) were discovered using both high and low colour imaging. There have been 83 occurrences of placental lakes and rivers found. This seems to be a unique type of prenatal PAS screening performed using sonographic imaging. These findings have clinical implications for the detection of PAS and may help guide the obstetric management of patients diagnosed with these placental disorders. The improved ability to suspect and detect PAS during ultrasound imaging allows proper referral to specialist centers, preparation for delivery by a multidisciplinary team and decreased maternal–fetal medicine morbidity and mortality.

Dr. Eric Edwin Yuliantara has completed his Obstetrics and Gynecology Specialist in 2007 from Sebelas Maret University, Indonesia and his Fetomaternal Medicine Fellowship Program from Airlangga University, Indonesia in 2015. He is the head of the Department of Obstetrics and Gynecology at Moewardi’s General Hospital and also the head lecturer of the Obstetrics and Gynecology Specialist Program at Sebelas Maret University. He has been serving as a speaker at several national Obstetricians and Gynecologist conferences. He also has many publications about fetomaternal, obstetrics emergency, and placenta accreta in some reputed journals.