When the placental villi invade the myometrium, the placenta is termed:
A. Placenta Accreta
B. Placenta increta
C. Placenta percreta
D. Placenta extrachorialis
Correct Answer: B. Placenta increta
Explanation
When the placental villi invade the myometrium, the condition is called Placenta Increta.
Here’s a breakdown of related terms for clarity:
- Placenta Accreta – The placental villi attach abnormally to the myometrium but do not invade it.
- Placenta Increta – The placental villi invade into the myometrium. ✅
- Placenta Percreta – The placental villi penetrate through the myometrium and may reach surrounding organs like the bladder.
- Placenta Extrachorialis – This term refers to a placenta with villi extending beyond the chorionic plate, not related to myometrial invasion.
So the correct answer here is Placenta Increta.
Other Options Details
Here’s a detailed explanation of each option regarding abnormal placental attachment and related conditions:
A. Placenta Accreta
- Definition: A condition where the placenta attaches too deeply into the uterine wall but does not penetrate the uterine muscle (myometrium).
- Pathophysiology: The normal decidua basalis (a layer of the uterine lining that separates placenta from uterus) is partially absent, allowing abnormal adherence.
- Clinical Significance: Can cause severe postpartum hemorrhage because the placenta cannot easily detach after delivery.
- Treatment: Often requires careful management, sometimes hysterectomy if bleeding is uncontrollable.
B. Placenta Increta
- Definition: The placenta invades into the myometrium (uterine muscle).
- Pathophysiology: More severe than accreta; the chorionic villi penetrate into the muscle layer, increasing the risk of complications.
- Clinical Significance: Higher risk of bleeding and may require surgical intervention or hysterectomy.
- Key Difference from Accreta: In accreta, placenta is attached to the muscle surface; in increta, it grows into the muscle.
C. Placenta Percreta
- Definition: The placenta penetrates through the entire uterine wall and may attach to adjacent organs (like bladder).
- Pathophysiology: Most severe form of abnormal placental attachment. The chorionic villi go beyond the myometrium and serosa.
- Clinical Significance: Can cause life-threatening hemorrhage during delivery and often requires hysterectomy with repair of other organs if involved.
- Key Difference from Increta: In percreta, placenta extends outside the uterus, sometimes involving other organs.
D. Placenta Extrachorialis
- Definition: A variant where the placenta extends beyond the chorionic plate margin, leaving the edge of the placenta uncovered by the chorion.
- Clinical Significance: Usually a minor anatomical variation; rarely associated with serious complications.
- Key Difference from the Others: Not an invasive condition like accreta/increta/percreta; it’s more of a placental shape/marginal anomaly.
✅ Summary Table: Condition Placental Invasion Severity Clinical Concern Accreta Adheres to myometrium Mild-Moderate Postpartum hemorrhage Increta Invades myometrium Moderate-Severe Bleeding, may need surgery Percreta Penetrates through uterus & may involve organs Severe Life-threatening bleeding, complex surgery Extrachorialis Extends beyond chorionic margin Minor Usually benign
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Writer: Vandita Singh, Lucknow (GS India Nursing Group