Jauniaux E, Hussein AH, Zosmer N, et al. - In the present study, the researchers assessed the role of a new methodological approach in correlating clinical and pathological data for women with a history of previous cesarean delivery that was diagnosed prenatally with placenta previa accreta. In a cohort of 24 patients with singleton pregnancies complicated by placenta low-lying/placenta previa accreta, they prospectively used a modified pathologic technique for gross examination of hysterectomy specimens with placenta in-situ consisting of intra-operative examination, immediate postoperative examination and guided histologic sampling. They performed a comparison of the findings with those noted for a group of 24 patients where a standard pathologic examination method was used. The study group vs the controls had significantly shorter median reporting time for obtaining the complete histopathology results including the microscopic examination (7 vs 15 days); significantly lower median number of samples taken for histologic examination (4 vs 14 samples); significantly higher number of histologic slides showing villous invasion (2 vs 1 slides); and significantly lower ratio of the number of samples taken to the numbers of slides confirming villous invasion (2 vs 9). All cases of the study group exhibited a dense tangled bed of vessels or multiple vessels running laterally and cranio-caudally in the uterine serosa above the placental insertion during the intra-operative examination; these were no longer visible during immediate gross postoperative examination of the hysterectomy specimens. Immediate postoperative dissection was identified as valuable for differential diagnosis between focal and large increta areas, and between abnormally adherent placenta and invasive placenta accreta. This methodological approach was supported as a cost-effective approach and valuable for increasing the quality of the histologic sampling. It thus allowed assessing more accurate correlations with the clinical data and performing more accurate epidemiologic data collection. Based on the findings they recommend including perinatal pathologists in multidisciplinary teams involved in the management placenta accreta spectrum disorders.