A woman with placenta praevia major (Type IV) undergoes caesarean at 37 weeks. Histology confirms placenta accreta spectrum. Which FIGO grading of placenta accreta spectrum indicates myometrial invasion but without reaching the serosa?

• A Grade 1 — placenta accreta
• B Grade 2 — placenta increta ✓
• C Grade 3a — placenta percreta without bladder invasion
• D Grade 3b — placenta percreta with bladder invasion

Explanation

The FIGO 2019 classification of placenta accreta spectrum (PAS) defines: Grade 1 (accreta) — abnormal trophoblast invasion but not into myometrium; Grade 2 (increta) — invasion into myometrium but not reaching serosa; Grade 3a (percreta) — invasion through serosa but not adjacent organs; Grade 3b — invasion into bladder; Grade 3c — invasion into other pelvic organs. Grade 2 (increta) specifically denotes myometrial invasion without serosal breach.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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