A woman with a previous uterine scar delivers by repeat caesarean. The placenta is adherent and cannot be separated. Intraoperative blood loss reaches 2.5 litres. On pathology the villi invade but do NOT penetrate through the uterine serosa. The FIGO 2018 classification for this placentation abnormality is:

• A Placenta accreta (Grade 1)
• B Placenta percreta (Grade 3a)
• C Placenta percreta (Grade 3c)
• D Placenta increta (Grade 2) ✓

Explanation

FIGO 2018 classifies placenta accreta spectrum (PAS) histologically: Grade 1 (accreta) — villi attached to myometrium without invasion; Grade 2 (increta) — villi invade into myometrium but not through serosa; Grade 3 (percreta) — villi invade through serosa, with sub-grades 3a (serosa only), 3b (bladder), 3c (other organs). Villi invading into but not penetrating the serosa = Grade 2 increta.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.