Etiopathogenesis and risk factors for placental accreta spectrum disorders

Ali, Humaira; Chandraharan, Edwin

doi:10.1016/j.bpobgyn.2020.07.006

Cited by 19 publications

(10 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…All anatomical changes characteristic for PAS disorders inside placental bed, decidua, placenta, myometrium and organs around the uterus, mainly posterior wall of bladder, have correspondence in US images that could be prenatally discovered. Despite this achieved medical performance nowadays, in lack of mandatory screening for PAS disorders one-half to two-thirds of cases remain prenatally undiagnosed [ 46 ]. To prevent the risk of hemorrhage any attempt to remove placenta when it is no possible to be detached spontaneously or under uterotonics medication must not occur.…”

Section: Methodsmentioning

confidence: 99%

Update on placenta accreta spectrum disorders by considering epidemiological factors, ultrasound diagnosis and pathological exam – literature review and authors’ experience

Stănculescu¹,

Brătilă²,

Socolov³

et al. 2022

Rom J Morphol Embryol

View full text Add to dashboard Cite

The aim of this paper was to correlate the circumstances that could lead to an abnormal invasion of placenta with the updated requirements to perform screening by ultrasound for all pregnant women prone to develop this pathology. To screen in the middle trimester of gestation for placenta accreta spectrum (PAS) disorders sets up an in-time referral opportunity for pregnant women prenatally detected with this pathology to a medical center with elevated level of expertise in the management of PAS disorders, able to act permanently by a multidisciplinary team (MDT) and to have access at medical resources including blood bank available. The literature review reveals especially useful data for clinical practice as regards novel explanations related to the etiology and physiopathology of PAS disorders, the composition of the MDT and the relevance of an indispensable pathologist physician at the time of Cesarean hysterectomy involved in the selection of best samples with the purpose of avoiding the possibility of losing undiagnosed cases with litigation implications. Conclusions show that the prenatal diagnosis of PAS disorders is possible so decreasing the risk of mortality and morbidity of pregnant women. Screening in the second trimester of pregnancy for PAS disorders becomes mandatory as the number of births by Cesarean section is expected to rise past three-fold until 2030. The professional expertise of the pathologist physician could be enriched by immunohistochemical staining in all suspected cases of placental invasion in myometrium wall.

show abstract

Section: Methodsmentioning

confidence: 99%

Update on placenta accreta spectrum disorders by considering epidemiological factors, ultrasound diagnosis and pathological exam – literature review and authors’ experience

Stănculescu¹,

Brătilă²,

Socolov³

et al. 2022

Rom J Morphol Embryol

View full text Add to dashboard Cite

show abstract

“…In PAS, there is an imbalance in angiogenesis, namely an increase in angiogenic factors and a decrease in antiangiogenic factors 11,12,13 . One of the angiogenic factors was vascular endothelial growth factor (VEGF), which is produced by syncytiotrophoblast in greater numbers than in normal placentations, thereby increasing the degree of placental invasion of the uterine wall 14,15 . In our study, based on the results of the Kruskal Wallis test, it showed a signifi cance value of 0.264 (p> 0.05), which means that there was no signifi cant difference in VEGF between grade I, grade II, and grade III groups.…”

Section: Discussionmentioning

confidence: 99%

Vascular Endothelial Growth Factor (VEGF) Expression on Placenta Accreta Spectrum (PAS) FIGO Grading

Ana Puji Rahayu,

Agus Sulistyono,

Ernawati

et al. 2021

Indian Journal of Forensic Medicine & Toxicology

View full text Add to dashboard Cite

This study aims to analyze the role of placenta VEGF level using immunocytochemical techniques and comparing the obtained results with PAS FIGO grading. This retrospective cross sectional study on total sampling of formalin fixed paraffin-embedded tissue from placenta sampling of elective surgery which were diagnosed as PAS. Sample were immunostained using VEGF and semi-quantitatively Immuno Reactive Score (IRS) measured based on modified Remmele scale index. The result obtained 32 samples that meet inclusion criteria which are found into grade I (n=5), grade II (n=11) and grade III (n=16). This study showed average VEGF at grade I (4.68±1.03), grade II (3.81±1.41), grade III (4.46±1.82) and no significant difference of VEGF expression between grade I, grade II and grade III (p = 0.264). Intraplacental VEGF do not describe the severity of PAS FIGO grading.

show abstract

“…PPH occurring within 24 h of delivery was classified as primary PPH, while PPH occurring at least 24 h after delivery, but within 6 weeks postpartum, was classified as secondary PPH [24]. The placenta accreta spectrum (PAS) refers to the range of pathologic adherence of the placenta, including placenta increta, placenta percreta, and placenta accreta [25].…”

Section: Methodsmentioning

confidence: 99%

The Efficacy of Transarterial Embolization for Postpartum Hemorrhage Complicated with Disseminated Intravascular Coagulation: A Single-Center Experience

Ochiai

Nakatsuka

Abe

et al. 2021

JCM

View full text Add to dashboard Cite

Indications for the use of transarterial embolization (TAE) for postpartum hemorrhage (PPH) have been established. However, the efficacy of TAE for PPH complicated by disseminated intravascular coagulation (DIC) remains controversial. In this study, we investigated the efficacy of TAE for PPH complicated by DIC. A database review was conducted to identify patients who were treated with TAE for PPH at our hospital. TAE was performed in 41 patients during the study period. Effective hemostasis was achieved in all cases, but additional procedures, such as re-embolization or hysterectomy, were required in five patients (12.2%). The typical causes of PPH included uterine atony (18 cases), placenta previa (15 cases), amniotic fluid embolism (DIC-type) (11 cases), and placenta accreta spectrum (10 cases). The mean blood loss was 3836 mL. The mean obstetrical DIC and the International Society on Thrombosis and Hemostasis DIC scores were 7.9 and 2.6, respectively. The efficacy of hemostasis was comparable between patients with and without DIC. However, the complete success rate of TAE was lower in patients with DIC as the condition worsened than that in non-DIC patients. Overall, TAE is effective as a minimally invasive treatment for PPH complicated by DIC.

show abstract

Etiopathogenesis and risk factors for placental accreta spectrum disorders

Cited by 19 publications

References 23 publications

Update on placenta accreta spectrum disorders by considering epidemiological factors, ultrasound diagnosis and pathological exam – literature review and authors’ experience

Update on placenta accreta spectrum disorders by considering epidemiological factors, ultrasound diagnosis and pathological exam – literature review and authors’ experience

Vascular Endothelial Growth Factor (VEGF) Expression on Placenta Accreta Spectrum (PAS) FIGO Grading

The Efficacy of Transarterial Embolization for Postpartum Hemorrhage Complicated with Disseminated Intravascular Coagulation: A Single-Center Experience

Contact Info

Product

Resources

About