Figure 20a. Uterine dehiscence in a 24-year-old woman with vaginal bleeding and pelvic pain approximately 1 month after cesarean section. US findings were suggestive of a blood clot anterior to the uterus, but a myometrial defect could not be identified. (a) Sagittal T2-weighted image shows a large, anterior, transmural myometrial defect (arrows). No normal myometrial coverage is visible, and an adjacent complex fluid collection is present. (b) Axial fat-suppressed T1-weighted image shows that the fluid anterior to the uterus has high signal intensity (arrow), a finding consistent with blood products. At surgery, transmural myometrial necrosis was present in addition to retained placental tissue, which was suspicious for placenta accreta.