A 35-year-old G4P3 undergoes cesarean section for complete placenta previa. At delivery, the placenta is found to be densely adherent and cannot be removed. Intraoperative blood loss is 2.8 L. Hysterectomy is performed. Histopathology of the uterus most likely shows:

• A Chorionic villi adherent to myometrium without intervening decidua, not invading muscle
• B Chorionic villi confined within the endometrial cavity
• C Molar villi with trophoblastic hyperplasia
• D Chorionic villi invading through the myometrium into the perimetrium ✓

Explanation

Placenta percreta is defined by chorionic villi penetrating entirely through the myometrium and breaching the serosa (perimetrium), sometimes invading adjacent organs such as the bladder. Placenta accreta has villi attached to myometrium without intervening decidua but not invading muscle; placenta increta has villi invading into the myometrium. The scenario of dense adherence requiring hysterectomy in a high-parity patient with previa is most consistent with percreta in this question's histopathological description.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.