Question

A 32-year-old G5P4 at 37 weeks presenting for a third repeat cesarean section is found on ultrasound to have placenta previa. The risk of placenta accreta in this patient is

A. Similar to that in the general obstetric population
B. Approximately 10%
C. Increased only if an endometrial strip is visible on ultrasound
D. Approximately 60%
E. At least 95%; all placenta previa is associated with accreta

Answer 1

The risk of placenta accreta in a patient with placenta previa and a history of prior cesarean deliveries is much higher than in the general population. For a patient with a history of multiple cesareans like the case described, the risk is approximately 60%.

Step-by-step explanation:

The risk of placenta accreta in a patient with placenta previa and a history of previous cesarean sections is significantly increased compared to the general obstetric population. While placenta previa itself occurs in only about 0.5 to 1 percent of all pregnancies and is a condition where the placenta partially or completely covers the cervix, the risk of placenta accreta increases with the number of prior cesarean deliveries.

In this patient's case, being a 32-year-old G5P4 at 37 weeks with a history of two previous cesarean sections and now found to have placenta previa, the risk of placenta accreta is significantly higher than that of the general obstetric population. The risk is not as high as 95%, which would imply that nearly all cases of placenta previa are associated with accreta, nor is it as low as the general population. The most accurate answer, in this case, is that the risk of placenta accreta is approximately 60%, reflecting the increased likelihood due to the patient's obstetric history.