A placental condition defined as abnormal trophoblast invasion of part or all of the placenta into the myometrium of the uterine wall is known as?

1. A

   Placenta Accreta

2. B

   Placenta Percreta

3. C

   Placenta Increta

4. D

   Placenta previa

Appeared in: NORCET 2 - 2021 (shift-1)

Explanation

• The question describes a condition where trophoblasts invade into the myometrium.
• Placenta increta is the specific medical term for the invasion of chorionic villi into the muscular layer (myometrium) of the uterus.
• This is distinct from placenta accreta (attachment to the myometrium) and placenta percreta (invasion through the myometrium).
• The provided image visually confirms that 'Increta' represents invasion into the uterine muscle wall.

Why Other Options Were Wrong

• Option A: Placenta accreta involves the chorionic villi attaching to the surface of the myometrium, but not invading into the muscle tissue.
• Option B: Placenta percreta is a more severe condition where the villi penetrate completely through the myometrium and can invade adjacent organs like the bladder.
• Option D: Placenta previa describes the location of the placenta, where it covers or is near the internal cervical os. It is an issue of position, not invasion depth.

Related Visual

• Visual 1: Diagram - A cross-section of the uterine wall showing the endometrium, myometrium, and serosa. Arrows should indicate the depth of placental invasion for accreta (attaches to myometrium), increta (invades into myometrium), and percreta (invades through myometrium). This helps visually differentiate the levels of the Placenta Accreta Spectrum.
• Visual 2: Infographic - A chart listing the primary risk factors for Placenta Accreta Spectrum, such as prior cesarean delivery, placenta previa, prior uterine surgery, and advanced maternal age.

Clinical Relevance

• Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Abnormal placental implantation and the Placenta Accreta Spectrum (PAS) as background academic context rather than a clinical decision trigger.
• The primary clinical concern with Placenta Accreta Spectrum (PAS) is the risk of massive, life-threatening postpartum hemorrhage because the placenta fails to separate from the uterine wall after delivery.
• Management requires a multidisciplinary team and a planned cesarean delivery, often with a hysterectomy (cesarean-hysterectomy) to control bleeding.
• Nursing preparation is critical: ensure at least two large-bore IVs are in place, blood products are typed and cross-matched, and the massive transfusion protocol is ready to be activated.

How to Approach the Question

• This is a factual recall question based on definitions.
• First, identify the key descriptive phrase in the question stem: "invasion of... the placenta into the myometrium".
• Next, recall the definitions for each of the options provided.
• Differentiate the three types of the Placenta Accreta Spectrum: Accreta (adherence), Increta (invasion into), and Percreta (invasion through).
• Recognize that Placenta Previa relates to the placenta's location over the cervix, not its depth of attachment.
• Match the definition in the stem ("into the myometrium") with the correct term, which is Placenta Increta.

Concept Tested & Keywords

• Concept Tested: Abnormal placental implantation and the Placenta Accreta Spectrum (PAS).
• Stem keywords: placental condition, abnormal trophoblast invasion, into the myometrium, uterine wall
• Lead-in keywords: is known as

Question ID

QNP0vWPIS1VSQkzAWnG5Ci

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