Which placental condition involves invasion through the uterine serosa and possibly into adjacent organs?

• A. Placenta accreta
• B. Placenta increta
• C. Placenta previa
• D. Placenta percreta

Answer: (D)

Placenta accreta spectrum is defined by how deeply placental tissue attaches and invades the uterine wall. In the most severe form, placenta percreta, the placental tissue not only invades through the myometrium and penetrates the uterine serosa but can extend into adjacent organs such as the bladder. This distinguishes it from placenta accreta, where the placenta attaches to the surface of the myometrium without deep invasion, and placenta increta, where the invasion goes into the myometrium but does not break through the serosa. Placenta previa, by contrast, involves placenta location over or near the cervical os and is not about invasion into the uterine wall. Because percreta can cause heavy hemorrhage and involve nearby organs, delivery planning often includes cesarean hysterectomy and careful maternal-fetal management.