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OBG · Obstetric emergencies: placenta accreta spectrum
Sample itemWhich woman has the highest risk of placenta accreta?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Placenta praevia with two previous caesarean sections
The risk of placenta accreta spectrum rises with praevia and number of previous caesarean sections (roughly 40 to 60 per cent or more with praevia and two or more scars). Diagnosis is by ultrasound and MRI. Planned caesarean hysterectomy with the placenta left in situ is the standard, ideally at a tertiary centre.
Option by option
A. Placenta praevia with two previous caesarean sections (correct)
Correct. Praevia over a scar is the main risk combination.
B. Previous normal delivery with posterior placenta
A posterior placenta without scars has low risk.
C. Grand multipara with no scar
Absence of scars lowers the risk.
D. Primigravida with fundal placenta
A fundal placenta in a primigravida with no scar has low risk.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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