Cramer, Stewart F. & Hatem, Fadi & Heller, Debra (2019). Placenta increta presenting as retained placenta: a report of 3 cases. Fetal and Pediatric Pathology Retrieved from https://doi.org/doi:10.7282/t3-9vjx-4m55
AbstractObjectives: Morbid adherence is a risk factor for retained placenta(RP). We encountered 3 cases of placenta increta presenting clinically as delayed postpartum hemorrhage.
Methods: This was a retrospective study of 3 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 3 cases had basal plate myofibers (BPMF) in the placenta, with BPMF recurrence in the 2 cases with another pregnancy.
Conclusion: RP may be a presenting clinical manifestation of placenta increta.
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