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.
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