Placenta accreta spectrum is most strongly associated with which obstetric history factor?

Placenta accreta spectrum is most strongly associated with which obstetric history factor?

• A. Prior cesarean deliveries
• B. First pregnancy
• C. No prior imaging
• D. Maternal smoking

Answer: (A)

Placenta accreta spectrum arises when placental tissue attaches to or invades the uterine wall because the normal decidual layer is disrupted. Uterine scarring from prior cesarean deliveries creates areas where the decidua basalis is deficient, allowing placental villi to adhere to or invade the myometrium more deeply than normal. The presence and number of prior cesarean sections are the strongest history-linked risk factors, and the risk rises with each additional cesarean. While other factors like placenta previa can amplify the risk, a history of prior cesarean deliveries alone is the most influential predictor. In contrast, being in the first pregnancy, having no prior imaging, or maternal smoking do not carry the same strong association with PAS.

Placenta accreta spectrum arises when placental tissue attaches to or invades the uterine wall because the normal decidual layer is disrupted. Uterine scarring from prior cesarean deliveries creates areas where the decidua basalis is deficient, allowing placental villi to adhere to or invade the myometrium more deeply than normal. The presence and number of prior cesarean sections are the strongest history-linked risk factors, and the risk rises with each additional cesarean. While other factors like placenta previa can amplify the risk, a history of prior cesarean deliveries alone is the most influential predictor. In contrast, being in the first pregnancy, having no prior imaging, or maternal smoking do not carry the same strong association with PAS.