This 24-year-old G2P1 patient presented at 27 weeks with complain of severe hemorrhagia and abundant clots. The uterus is irritable and hard. The patient improved after medical care and rest. The following images were obtained 5 days after admission:

The placenta demonstrated a very large bleed, consistent with an abruption.

One of the cerebral hemisphere is diffusely echogenic. This does not represent a well-delineated mass, but a large intracranial hemorrhage.

Doppler studies:

The fetus did not survive and the autopsy confirmed the prenatal suspicion of large placental abruption resulting in a massive intracranial hemorrhage.