This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Obstetrics, Subject name: Gynaecology & Obstetrics
A 30-year-old G2P1 is undergoing an elective repeat caesarean section at term. The infant is delivered without any dificulties, but the placenta cannot be removed easily because a clear plane between the placenta and uterine wall cannot be identified. The placenta is removed in pieces. This is followed by uterine atony and haemorrhage. All of the following are true regarding the condition except 
Select and explain. 
A. Previous LSCS is a predisposing factor, B. Absence of Nitabuch's membrane, C. May require obstetric hysterectomy, D. If Placenta invades muscle and reaches serosa it is known as placenta increta
D: If Placenta invades muscle and reaches serosa it is known as placenta increta
Answer: D: If Placenta invades muscle and reaches serosa it is known as placenta increta 
Explanation: With placenta accreta a cesarean hysterectomy may be required. This is because there is uncontrollable bleeding often when placental delivery is attempted. Hysterectomy is frequently required since regular methods of reducing bleeding with suturing mostly don't work. Nitabuch's layer limits invasion of the decidua by the trophoblast. The membrane is absent in the placenta accreta. It causes morbid adhered placenta Placenta accreta:- Paial or complete absence of decidua with adherence of placenta directly to the superficial myometrium Placenta increta :- Villi invade into but not through the myometrium Placenta percreta :- Villi invade through the full thickness of myometrium to the serosa