Placenta Increta Presenting as Retained Placenta: A Report of 3 Cases

Department

Pathology

Document Type

Article

Publication Title

Fetal And Pediatric Pathology

Abstract

OBJECTIVES: Morbid adherence is a risk factor for retained placenta (RP). We encountered three cases of placenta increta presenting clinically as delayed postpartum hemorrhage. METHODS: This was a retrospective study of three cases of placenta increta presenting as RP. RESULTS: One "routine" term placenta had heavy bleeding 2 weeks later; one missed abortion at 16 weeks with fetal and placental tissue submitted, had heavy bleeding 6 weeks later; and one elective abortion (no tissue submitted), had delayed postpartum bleeding leading to a curettage with blood only, then 6 weeks later a hysterectomy for menorrhagia. All 3 pathology specimens showed necrotic villi. However, all three also showed myometrium with keratin-positive interstitial trophoblasts in a zone of damaged myometrium, consistent with increta. All three cases had basal plate myofibers (BPMF) in the placenta, with BPMF recurrence in the two cases with another pregnancy. CONCLUSION: RP may be a presenting clinical manifestation of placenta increta.

First Page

215

Last Page

225

DOI

10.1080/15513815.2019.1582121

Volume

38

Issue

3

Publication Date

6-1-2019

Medical Subject Headings

Adult; Female; Hemorrhage (diagnosis, pathology); Humans; Placenta (pathology); Placenta Accreta (pathology); Placenta, Retained (pathology); Pregnancy; Retrospective Studies; Trophoblasts (pathology)

PubMed ID

30888250

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