Placenta Accreta Spectrum: A Review of Pathology, Molecular Biology, and Biomarkers

Bartels, H; Postle, James D.; Downey, Paul; Brennan, Donal J.

doi:10.1155/2018/1507674

Cited by 166 publications

(155 citation statements)

References 93 publications

(88 reference statements)

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“…It will be essential to placental epigenetics research to develop DNAm references for other placental cell subtypes. This will be especially important in studies on placental pathologies (and likely also in many other phenotypes), where certain TB subtypes are more affected than others, such as preeclampsia (58) and placenta accreta (59). Associated changes in cell composition with preeclampsia may explain the nding that many CpGs with altered DNAm in preeclampsia (30) are also highly cell-speci c. Cellular heterogeneity will always be a challenge when using techniques that take measurements in samples that consist of a mixed population of cells.…”

Section: Cell-speci C Dnam Dynamics Across Gestationmentioning

confidence: 99%

Cell-specific Characterization of the Placental Methylome

Yuan

Hui²,

Yin

et al. 2020

Preprint

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Background: DNA methylation (DNAm) profiling has emerged as a powerful tool for characterizing the placental methylome. However, previous studies have focused primarily on whole placental tissue, which is a mixture of epigenetically distinct cell populations. Here, we present the first methylome-wide analysis of first trimester (n=9) and term (n=19) human placental samples of four cell populations: trophoblasts, Hofbauer cells, endothelial cells, and stromal cells, using the Illumina EPIC methylation array, which quantifies DNAm at >850,000 CpGs.Results: The most distinct DNAm profiles were those of placental trophoblasts, which are central to many pregnancy-essential functions, and Hofbauer cells, which are a rare fetal-derived macrophage population. Cell-specific DNAm occurs at functionally-relevant genes, including genes associated with placental development and preeclampsia. Known placental-specific methylation marks, such as those associated with genomic imprinting, repetitive element hypomethylation, and placental partially methylated domains, were found to be more pronounced in trophoblasts and often absent in Hofbauer cells. Lastly, we characterize the cell composition and cell-specific DNAm dynamics across gestation.Conclusions: Our results provide a comprehensive analysis of DNAm in human placental cell types from first trimester and term pregnancies. This data will serve as a useful DNAm reference for future placental studies, and we provide access to this data via download from dbGAP (phs002013.v1.p1), through interactive exploration from the web browser (https://robinsonlab.shinyapps.io/Placental_Methylome_Browser/), and through the R package planet, which allows estimation of cell composition directly from placental DNAm data.

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Section: Cell-speci C Dnam Dynamics Across Gestationmentioning

confidence: 99%

Cell-specific Characterization of the Placental Methylome

Yuan

Hui²,

Yin

et al. 2020

Preprint

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“…The PAS is a multifactorial complex: abnormal decidualization, abnormal maternal vascular remodeling and increased trophoblastic invasion are the important cause of the PAS [2]. Decidua is the source of the VEGF and PLGF and with the paracrine mechanism regulate the trophoblastic invasion [18].…”

Section: Discussionmentioning

confidence: 99%

“…With the rising rate of cesarean section (C/S) worldwide, placenta accreta is considered as a new pathological matter [1]. According to the depth of invasion of placenta to myometrium, the placenta accreta spectrum (PAS), formerly known as morbidly adherent placenta, is divided into three groups: placenta accreta with superficial myometrial invasion, placenta increta with deep myometrial invasion, and placenta percreta with deep invasion of placenta to serosa of uterus and sometime to adjacent organs [1,2].…”

Section: Introductionmentioning

confidence: 99%

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Predictive value of vascular endothelial growth factor and placenta growth factor for morbidly adherent placenta among women with previous history of cesarean section

Asadi¹,

Akbarzadeh‐Jahromi²,

Faraji³

et al. 2020

Preprint

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Background The present study aims to determine the predictive value of vascular endothelial growth factor (VEGF) and placenta growth factor (PLGF) for placenta accreta and for the comparison of the serum level of VEGF and PLGF in normal pregnant women and women with placenta accreta spectrum (PAS).Methods This prospective case-control study was conducted during the 2 years in two hospital in Shiraz, Iran from 2017 to 2019. The inclusion of the study was 90 singleton pregnant women: 45 of them in gestational ages of 28-34 weeks with pathological confirmation of placenta accreta spectrum and 45 healthy pregnant women. In the PAS group, according to pathology reports on the placenta, we divided all cases to placenta accreta, percreta, and increta. Maternal serum level of VEGF and PLGF were measured before the termination of pregnancy and diagnostic accuracy of each factor was evaluated.Results In PAS group, 75 percent of patients had placenta previa and unlike the control group, there was a significant difference in the gravidity, number of cesarean section, maternal age, and serum level of PLGF (p< /001); while in VEGF, the difference was not statistically significant. ConclusionsThe results of the present study revealed that the maternal serum level of PLGF could be considered as an accurate predictive test in patients with PAS. BackgroundWith the rising rate of cesarean section (C/S) worldwide, placenta accreta is considered as a new pathological matter [1]. According to the depth of invasion of placenta to myometrium, the placenta accreta spectrum (PAS), formerly known as morbidly adherent placenta, is divided into three groups: placenta accreta with superficial myometrial invasion, placenta increta with deep myometrial invasion, and placenta percreta with deep invasion of placenta to serosa of uterus and sometime to adjacent organs [1,2].In normal placentation, extravillous trophoblasts containing interstitial and endovascular cells invade decidua and superficial myometrium and cause remodeling of the basilar and spiral artery [3, 4].Thus, excessive trophoblastic invasion, abnormal decidualization, abnormal angiogenesis, and 4 decrease of apoptosis of trophoblasts can result in abnormal adherence of placenta [5, 6].In uterine scars such as site of C/S, total or partial absence of decidua, thinning, irregularity or absence of Nitabuch's layer, and subsequently, placenta accreta can happen [4,[7][8][9].Also, deficient trophoblastic invasion can be harmful and is related to abortion, preeclampsia, intrauterine growth restriction (IUGR), and preterm delivery [3].The most important risk factors of PAS are previous C/S and intrauterine operation [10][11][12]. Other risk factors included placenta previa, multiparity, maternal age, any previous uterine surgery, surgical abortion, radiation, endometrial ablation, in vitro fertilization (IVF), chemotherapy, and adenomyosis [7,[10][11][12].The rate of C/S in the United States is 32-33% and placentas accreta is equal to 1/540-1/2500 of total deliveries[1]. It has increased...

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“…It will be essential to placental epigenetics research to develop DNAm references for other placental cell subtypes. This will be especially important in studies on placental pathologies (and likely also in many other phenotypes), where certain TB subtypes are more affected than other, such as preeclampsia (57) and placenta accreta (58). Associated changes in cell composition with preeclampsia may explain the nding that many CpGs with altered DNAm in preeclampsia (29) are also highly cell-speci c. Cellular heterogeneity will always be a challenge when using techniques that take measurements in samples that consist of a mixed population of cells.…”

Section: First Trimester Termmentioning

confidence: 99%

Cell-specific Characterization of the Placental Methylome

Yuan

Hui²,

Yin

et al. 2020

Preprint

View full text Add to dashboard Cite

Abstract Background DNA methylation (DNAm) profiling has emerged as a powerful tool for characterizing the placental methylome. However, previous studies have focused primarily on whole placental tissue, which is a mixture of epigenetically distinct cell populations. Here, we present the first methylome-wide analysis of first trimester (n = 9) and term (n = 19) human placental samples of four cell populations: trophoblasts, Hofbauer cells, endothelial cells, and stromal cells, using the Illumina EPIC methylation array, which quantifies DNAm at > 850,000 CpGs. Results The most distinct DNAm profiles were those of placental trophoblasts, which are central to many pregnancy-essential functions, and Hofbauer cells, which are a rare understudied macrophage population thought to derive from fetal monocytes. Cell-specific DNAm occurs at functionally-relevant genes, including genes associated with placental development and preeclampsia. Known placental-specific methylation marks, such as those associated with genomic imprinting, repetitive element hypomethylation, and placental partially methylated domains, were found to be more pronounced in trophoblasts and often absent in Hofbauer cells. Lastly, we characterize the cell composition and cell-specific DNAm dynamics across gestation. Conclusions Our results provide a comprehensive analysis of DNAm in human placental cell types from first trimester and term pregnancies. This data will serve as a useful DNAm reference for future placental studies, and we provide access to this data via download from dbGAP (phs002013.v1.p1), through interactive exploration from the web browser (https://robinsonlab.shinyapps.io/Placental_Methylome_Browser/), and through the R package planet, which allows estimation of cell composition directly from placental DNAm data.

show abstract

Placenta Accreta Spectrum: A Review of Pathology, Molecular Biology, and Biomarkers

Cited by 166 publications

References 93 publications

Cell-specific Characterization of the Placental Methylome

Cell-specific Characterization of the Placental Methylome

Predictive value of vascular endothelial growth factor and placenta growth factor for morbidly adherent placenta among women with previous history of cesarean section

Cell-specific Characterization of the Placental Methylome

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