A condition in which the placenta is directly attached to the myometrium?

Appeared in: AIIMS Raipur NO - 2019 (Shift-2)

Explanation

Placenta accreta is a condition where the placental villi abnormally adhere directly to the myometrium (uterine muscle).
This occurs due to a defect or absence of the decidua basalis (Nitabuch's layer), which normally separates the placenta from the myometrium.
The question's description of the placenta being 'directly attached to the myometrium' is the precise definition of placenta accreta.

Option A: This describes a marginal insertion of the umbilical cord at the edge of the placenta, not abnormal placental attachment to the uterine wall.
Option B: This refers to the umbilical cord inserting into the fetal membranes, with vessels running unprotected before entering the placenta. This is an issue of cord insertion, not placental invasion.
Option C: This describes the location of the placenta in the lower uterine segment, partially or completely covering the cervix. It does not relate to the depth of placental attachment to the uterine wall.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Abnormal Placentation / Placenta Accreta Spectrum as background academic context rather than a clinical decision trigger.
Placenta Accreta Spectrum (PAS) is a life-threatening condition primarily due to the risk of massive, uncontrollable postpartum hemorrhage when attempts are made to separate the placenta.
The incidence has risen dramatically with the increasing rate of cesarean deliveries, as prior uterine scarring is a major risk factor.
Management often requires a planned preterm cesarean hysterectomy by a multidisciplinary team at a tertiary care center to minimize maternal morbidity and mortality.

How to Approach the Question

This is a factual recall question testing knowledge of obstetric terminology.
First, identify the key terms in the question: 'placenta,' 'directly attached,' and 'myometrium.'
Next, analyze the options based on their definitions.
'Accreta' means to adhere or grow onto. This aligns with the description of attachment to the myometrium.
'Praevia' means 'in the way,' referring to its location over the cervix.
'Battledore' and 'velamentous' refer to umbilical cord insertion types, not placental attachment.

Concept Tested & Keywords

Qd47BxQIuoHE_SiXu81vmo

E6 Obstetrics Williams p. 73-89

Practise the full AIIMS Raipur NO - 2019 (Shift-2)

Attempt every question from this paper in a timed mock, then review the full solution for each one.