Which factors increase the risk for placenta accreta spectrum?

Which factors increase the risk for placenta accreta spectrum?

• A. Prior cesarean deliveries and placenta previa
• B. Young age and lack of prior pregnancies
• C. Gestational diabetes only
• D. Hyperemesis gravidarum

Answer: (A)

The key concept is that placenta accreta spectrum is strongly linked to placental bed abnormalities from previous uterine surgery, especially when placenta previa is present. When a uterus has scar tissue from prior cesarean deliveries, the normal decidual layer at the placental interface can be disrupted, allowing placental villi to invade into the myometrium (accreta, increta, or percreta). Placenta previa places the placenta over the cervix, often overlapping scar tissue, which further increases the likelihood of abnormal placentation. The risk climbs with the number of prior cesarean sections. Other factors listed—younger age with no prior pregnancies, gestational diabetes alone, or hyperemesis gravidarum—do not have the same strong association with PAS.

The key concept is that placenta accreta spectrum is strongly linked to placental bed abnormalities from previous uterine surgery, especially when placenta previa is present. When a uterus has scar tissue from prior cesarean deliveries, the normal decidual layer at the placental interface can be disrupted, allowing placental villi to invade into the myometrium (accreta, increta, or percreta). Placenta previa places the placenta over the cervix, often overlapping scar tissue, which further increases the likelihood of abnormal placentation. The risk climbs with the number of prior cesarean sections. Other factors listed—younger age with no prior pregnancies, gestational diabetes alone, or hyperemesis gravidarum—do not have the same strong association with PAS.