Journal of Advances in Medicine and Medical Research

Background: Placenta previa is a recognised risk factor for placenta accreta spectrum (PAS); PAS was histologically confirmed in the hysterectomy specimens studied here.

Aims: To identify pathomorphological changes in the uterine myometrium after delivery in pregnancies complicated by placenta previa.

Study Design: Retrospective, descriptive histopathological study of explanted postpartum uteri.

Place and Duration of Study: Department of Pathological Anatomy, Samarkand State Medical University, using uteri explanted at the Samarkand branch of the Republican Scientific Practical Centre for Maternal and Child Health, during 2025 and 2026.

Methodology: Uteri from 24 postpartum women (aged 28–40 years; mean age, 36.6 years) were studied. Tissue pieces (0.5×1.0 cm) from the myometrial layer were fixed in 10% formalin, dehydrated, and paraffin-embedded. Sections 5–7 µm thick were stained with haematoxylin-eosin, Van Gieson’s, and Weigert’s methods.

Results: A large amount of blood was observed in the interstices between myocytes. Massive diapedetic haemorrhages were noted at placental attachment sites, together with diffuse leucocyte infiltration and severe intermuscular oedema. Hydropic dystrophy was observed in most myocytes, accompanied by active fibroblast proliferation and dystrophic/necrotic changes in the interstitial arteries.

Conclusion: The postpartum uterine myometrium in pregnancies complicated by placenta previa shows a consistent pattern of haemorrhagic, dystrophic, and proliferative changes, dominated by diapedetic haemorrhage, leucocyte infiltration, intermuscular oedema, hydropic dystrophy, and fibroblast proliferation. Without a normal postpartum control group, these changes are best interpreted as tissue injury and repair, not previa-specific findings.