Placenta accreta: Pathogenesis of a 20th century iatrogenic uterine disease

Jauniaux, Eric; Jurkovic, D.

doi:10.1016/j.placenta.2011.11.010

Cited by 337 publications

(340 citation statements)

References 84 publications

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“…Jauniaux et al 4 recently supported this concept of a primary iatrogenic deciduomyometrium defect in placenta accreta, with failure of decidualization in the area of a previous uterine scar, which exposes the myometrium to trophoblastic invasion and subsequent excessive vascular remodeling of the radial and arcuate arteries below the junctional zone. However, while these mechanisms may explain how the placentation is abnormal in depth and vasculature, they do not explain abnormal location.…”

Section: Correspondencementioning

confidence: 96%

Does the presence of a uterine scar influence the site of placental implantation?

Carbillon

2013

Ultrasound in Obstet & Gyne

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CorrespondenceDoes the presence of a uterine scar influence the site of placental implantation? Naji et al. 1 compared the incidence of low-lying placenta in 738 patients who had one previous Cesarean section (CS) (594 women) or more than one previous CS (144 women) with 1856 controls in a case-control study. A low-lying placenta overlapping the CS scar increases dramatically the risk of placenta accreta with its major complications 2 , and prospective studies investigating placental location can make considerable contributions to the appropriate management of patients with one or more previous CS. Naji et al. did not find a significant difference in the incidence of low-lying placenta in patients with one or more previous CS compared with controls, although they concluded that the presence of a uterine scar did influence placentation, with more posterior and fewer fundal placentae in the CS group.Actually, several population-based studies 2,3 have demonstrated that women whose first delivery was by CS have a significantly increased risk of placenta previa at their second delivery compared with women with prior vaginal deliveries, with an increase in relative risk of 1.5 2,3 , and in those whose first two deliveries were by CS, the relative risk is higher still (2.0; 95% CI, 1.3-3.0) 3 compared with that in women whose first two deliveries were vaginal. The population of the CS group in Naji et al.'s study was probably not sufficiently powered to detect this association.Naji et al. 1 suggested diverse mechanisms that could explain abnormal placentation after CS, specifically disruption of the junctional zone and impaired decidualization. Jauniaux et al. 4 recently supported this concept of a primary iatrogenic deciduomyometrium defect in placenta accreta, with failure of decidualization in the area of a previous uterine scar, which exposes the myometrium to trophoblastic invasion and subsequent excessive vascular remodeling of the radial and arcuate arteries below the junctional zone. However, while these mechanisms may explain how the placentation is abnormal in depth and vasculature, they do not explain abnormal location. Naji et al. found that women with a low-lying placenta were significantly older than were women with a fundal placenta. The risk of placenta accreta is particularly high when the trophoblast overlaps the scar, and maternal age, which correlates both with low-lying placenta 1,5 and with previous CS 2,3 , could be the link. The population of the CS group in the study of Naji et al. was probably not sufficiently powered to detect this association either. Miller et al. 2 also showed that among women with placenta previa, advanced maternal age (≥35 years) and previous CS delivery are independent risk factors for placenta previaaccreta, which is a major and increasing cause of heavy postpartum hemorrhage 2 .L. Carbillon

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Section: Correspondencementioning

confidence: 96%

Does the presence of a uterine scar influence the site of placental implantation?

Carbillon

2013

Ultrasound in Obstet & Gyne

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“…The recent review article by Jauniaux et al 1 highlights the increasing interest in mechanisms that may impair adequate decidualization. It is thought that decidualization determines the length of the implantation window 2 .…”

Section: Replymentioning

confidence: 99%

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Naji¹,

Daemen

Smith

et al. 2013

Ultrasound in Obstet & Gyne

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“…Plasenta yapışma anomalileri ya da plasenta akreata; trofoblastların myometriuma değişik dercelerde invazyonuyla karakterize olup, tanımı ilk defa hidatiform mol gibi yüzyıllardır bilinen diğer plasenta anomalilerinin aksine 20. yüzyılda yapılmıştır (1) .…”

Section: Introductionunclassified

Can uterus be conserved in cases which unexpected placenta accreta is encountered during cesarean section ?

Kaya¹

2017

Okmeydani Medical Journal

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Placenta accreta: Pathogenesis of a 20th century iatrogenic uterine disease

Cited by 337 publications

References 84 publications

Does the presence of a uterine scar influence the site of placental implantation?

Does the presence of a uterine scar influence the site of placental implantation?

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Can uterus be conserved in cases which unexpected placenta accreta is encountered during cesarean section ?

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