A woman with placenta previa and three prior cesarean sections has ultrasound showing placental tissue invading through the myometrium into the bladder. The FIGO classification grade of placenta accreta spectrum (PAS) disorder in this case is:

• A PAS Grade 1 (Placenta accreta)
• B PAS Grade 2 (Placenta increta)
• C PAS Grade 3c (Percreta with pelvic sidewall involvement)
• D PAS Grade 3b (Placenta percreta with bladder invasion) ✓

Explanation

The FIGO 2018 classification of placenta accreta spectrum grades the condition by depth of invasion: Grade 1 (accreta) = abnormal adherence without myometrial invasion; Grade 2 (increta) = invasion into myometrium; Grade 3a = invasion through serosa; Grade 3b = invasion into bladder; Grade 3c = invasion into other pelvic organs or pelvic sidewall. Bladder invasion specifically designates Grade 3b. This classification guides surgical planning including the need for urology assistance and consideration of uterine conservation versus peripartum hysterectomy.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.