Assessment of Sensitivity and Specificity of Ultrasound and Magnetic Resonance Imaging in the Diagnosis of Placenta Accreta

Lopes, Elisa Santos; Feitosa, Francisco Edson de Lucena; Brazil, Antonio Viana; Castro, Jaelson; Costa, Juliana Nascimento da; Júnior, Edward Araujo; Peixoto, Alberto Borges; Carvalho, Francisco Herlânio Costa

doi:10.1055/s-0038-1675803

Cited by 20 publications

(18 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As the cesarean section rate increases, the incidence of AIP has increased over the past 50 years (14). It is difficult for patients with AIP to strip the entire placenta after delivery, which leads to serious obstetric complications, such as hemorrhages, hysterectomy, and even maternal mortality (15,16). The molecular mechanisms of invasive placentation in AIP are poorly understood; it might be a combination of primary absence of the decidua or basal plate, abnormal maternal vascular remodelling, and excessive EVT invasion (17) In summary, PE and AIP are consequences of two opposing trophoblast invasion disorders.…”

Section: Introductionmentioning

confidence: 99%

CCN3 Signaling Is Differently Regulated in Placental Diseases Preeclampsia and Abnormally Invasive Placenta

Duan

Schimmelmann

et al. 2020

Front. Endocrinol.

View full text Add to dashboard Cite

Objectives An adequate development of the placenta includes trophoblast differentiation with the processes of trophoblast migration, invasion, cellular senescence and apoptosis which are all crucial to establishing a successful pregnancy. Altered placental development and function lead to placental diseases such as preeclampsia (PE) which is mainly characterized by insufficient trophoblast invasion and abnormally invasive placenta (AIP) disorders ( Placenta accreta , increta , or percreta) which are characterized by excessive trophoblast invasion. Both of them will cause maternal and fetal morbidity/mortality. However, the etiology of these diseases is still unclear. Our previous study has shown that the matricellular protein nephroblastoma overexpressed (NOV, CCN3) induces G0/G1 cell cycle arrest, drives trophoblast cells into senescence and activates FAK and Akt kinases resulting in reduced cell proliferation and enhanced migration capability of the human trophoblast cell line SGHPL-5. The present study focuses on whether CCN3 can alter cell cycle-regulated pathways associated with trophoblast senescence and invasion activity in pathological versus gestational age-matched control placentas. Methods Cell cycle regulator proteins were investigated by immunoblotting and qPCR. For localization of CCN3, p16, p21, and Cyclin D1 proteins, co-immunohistochemistry was performed. Results In early-onset PE placentas, CCN3 was expressed at a significantly lower level compared to gestational age-matched controls. The decrease of CCN3 level is associated with an increase in p53, Cyclin E1 and pRb protein expression, whereas the level of cleaved Notch-1, p21, Cyclin D1, pFAK, pAKT, and pmTOR protein decreased. In term AIP placentas, the expression of CCN3 was significantly increased compared to matched term controls. This increase was correlated to an increase in p53, p16, p21, Cyclin D1, cleaved Notch-1, pFAK, pAkt, and pmTOR whereas pRb was significantly decreased. However, in late PE and early AIP placentas, no significant differences in CCN3, p16, p21, Cyclin D1, p53, and cleaved Notch-1 expression were found when matched to appropriate controls. Conclusions CCN3 expression levels are correlated to markers of cell cycle arrest oppositely in PE and AIP by activating the FAK/AKT pathway in AIP or down-regulating in PE. This may be one mechanism to explain the different pathological features of placental diseases, PE and AIP.

show abstract

Section: Introductionmentioning

confidence: 99%

CCN3 Signaling Is Differently Regulated in Placental Diseases Preeclampsia and Abnormally Invasive Placenta

Duan

Schimmelmann

et al. 2020

Front. Endocrinol.

View full text Add to dashboard Cite

show abstract

“…For patients with PA, dissection of the entire placenta during delivery is difficult, which may lead to intrapartum and postpartum hemorrhage. The average hemorrhage size is large, and it is the main cause of perinatal emergency hysterectomy (4). The maternal mortality rate associated with PA is a serious obstetric complication (5,6).…”

Section: Introductionmentioning

confidence: 99%

The role of Zeb1 in the pathogenesis of morbidly adherent placenta

Yang

et al. 2019

Mol Med Report

View full text Add to dashboard Cite

Zinc finger E-box-binding homeobox 1 (Zeb1) is a promoter of epithelial-mesenchymal transformation, which may serve an important role in morbidly adherent placenta (MAP). In the present study, the protein expression levels of Zeb1 were examined in the placenta tissues of 60 patients, including 20 patients with placenta accreta (PA) and 20 patients with placenta previa without PA (UPA) and 20 patients in late pregnancy that delivered by cesarean section (normal). The expression levels of Zeb1, N-cadherin, vascular endothelial growth factor (VEGF), Tumor necrosis factor-related apoptosis-inducing ligand-receptor 2 (TRAIL-R2), and tumor necrosis factor-related apoptosis-inducing ligand-receptor 3 (TRAIL-R3) were higher in PA tissues compared with in normal control tissues. The expression levels of E-cadherin and TRAIL-R2 were decreased in PA tissues compared with in normal control tissues. These findings indicated that Zeb1 may serve an important role in placental attachment, thus promoting the development of dangerous PA. Overexpression of Zeb1 may upregulate the expression levels of N-cadherin, VEGF, TRAIL-R3, cyclin D1 and Bcl-2, and downregulate the expression levels of E-cadherin and TRAIL-R2. In addition, Zeb1 regulated the viability, apoptosis and migration of HTR-8/SV neo cells and human umbilical vein endothelial cells by regulating the Akt pathway. In conclusion, these findings indicated that Zeb1 may promote placental implantation by activating the Akt signaling pathway, thus providing a theoretical basis for investigating the causes of MAP.

show abstract

“…Lopes et al, 19 reported that between the 37-cases (100%) who experienced the US, the PA-prevalence was 20 (54.2%) (95% confidence interval [95%CI]: 40.8-67.3).…”

Section: Discussionmentioning

confidence: 99%

Sonographic Detection of Placenta Accreta in The Second and third Trimesters of Pregnancy

Hamada¹,

Mohammad

Sadek

2021

Al-Azhar International Medical Journal

View full text Add to dashboard Cite

Background: the term morbid adherent placenta suggests a nontypical placental implantation into the uterine barrier and was utilized to express placental accreta, percreta, and increta. Placental accreta (PA) is a placental where the placenta villi stick on straightly to the myometrium. Objective: this work aim to evaluate the specificity, sensitivity, and diagnosis accurateness of ultrasound (US) in placental accretes diagnosing in the 2nd and 3rd trimesters of gestation. Patients and Methods: This was a prospective research that was performed at obstetrics and gynecology departments of both El Hussein and Kafr El-Sheikh Hospitals during the period between January 2020 till July 2020 aiming for evaluating the accurateness of US in the placenta accreta diagnosing. Results: The US sensitivity was (100 %), specificity was (85 %), NPV was (100 %) and PPV was (90.9%) with accuracy of (94%) in placental accreta diagnosing. Conclusion: Ultrasonography has satisfactory sensitivity for placental accreta diagnosing; but specificity doesn't seem to be good as concluded in other reports. US still the most sensitive and frequently utilized scanning modality for the placental accreta diagnosing as it is precise, cheap, and noninvasive and save time. This modality has excellent popularity as it is extensively accessible, patients friendly, and comparatively cheap.

show abstract

Assessment of Sensitivity and Specificity of Ultrasound and Magnetic Resonance Imaging in the Diagnosis of Placenta Accreta

Cited by 20 publications

References 24 publications

CCN3 Signaling Is Differently Regulated in Placental Diseases Preeclampsia and Abnormally Invasive Placenta

CCN3 Signaling Is Differently Regulated in Placental Diseases Preeclampsia and Abnormally Invasive Placenta

The role of Zeb1 in the pathogenesis of morbidly adherent placenta

Sonographic Detection of Placenta Accreta in The Second and third Trimesters of Pregnancy

Contact Info

Product

Resources

About