Placenta increta: Through the myometrium and beyond?

Placenta accreta is a general term used to describe abnormal placental attachment to the uterine wall. The degree of attachment is classified into three categories: accreta, increta, and percreta. Accreta is the most common and least severe form, with trophoblastic villi invading the superficial uterine myometrium. Invasion through the uterine myometrial layer is called placenta increta, whereas complete perforation through the uterine serosa and into adjacent organs is known as placenta percreta. Abnormal placental attachment is more likely in women with a history of endometrial scarring caused by previous cesarean sections, placenta previa, and curettage. Identifying women with associated risk factors is important because massive hemorrhage may occur if an accreta is undetected. Evaluation of the placenta using sonography and magnetic resonance imaging can prevent deadly complications and determine the best possible treatment options.