New Approaches to Morphological Diagnosis of Placenta Percreta: Clinical and Morphological Comparisons. Сase Report.

(1) Background If placenta percreta (PP) is suspected, one should take into account ultrasound and MRI data, which allow one to assess not only the depth of invasion of the placenta into the myometrium, but also the degree of involvement of the blood vessels of the uteroplacental region and the pelvis, the formation of adhesions and collaterals between organs as well; (2) Methods: The patient with suspected PP was examined by ultrasound and Magnetic Resonance Imaging (MRI) examination. Histological study was performed on paraffin sections (hematoxylin & eosin, Mallory staining); cytotrophoblast was detected with antibodies to cytokeratin-8; (3) Results MRI and ultrasound examinations showed placental invasion extending beyond the serous lining of the uterus involving the posterior wall of the bladder. Elective abdominal delivery was performed at 37 weeks. Surgical excision of the uterine wall with invaded villi and involved fibrous bladder wall were performed. Histological study revealed invasive cytotrophoblast cells in the uterine wall located up to adventitia of the uterine subserosal vessels only. Thinning of the uterine wall up to the serous membrane was detected; (4) Conclusions: Placental villi and trophoblast extended beyond the uterus is not histology equivalent to placenta percreta. To diagnose PP instrumental visualization methods should be used.