In the management of morbidly adherent placenta (placenta accreta spectrum), the 'Triple-P procedure' involves occlusion of internal iliac arteries, perioperative imaging, and what third component?

• A Prophylactic uterine compression sutures
• B Myometrial excision with placenta in situ
• C Balloon tamponade of the uterine cavity
• D Pelvic devascularization followed by placental site excision ✓

Explanation

The Triple-P procedure for placenta accreta spectrum involves: (1) perioperative placenta localization with ultrasound/MRI, (2) pelvic devascularization (occlusion of internal iliac arteries or uterine arteries), and (3) myometrial resection at the placental bed (placental site excision). This uterine-conserving approach attempts to avoid hysterectomy in carefully selected cases. It is different from the conservative approach (leaving placenta in situ) and is associated with significant hemorrhage risk. Most current guidelines recommend planned cesarean-hysterectomy by a multidisciplinary team as the standard care for placenta accreta spectrum disorders.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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