Placenta Increta

Abstract

A 38-year-old woman who had undergone three low-segment cesarean sections was admitted to the hospital in labor at 36 weeks of gestation. Antenatal ultrasonography suggested placenta accreta (Panel A), with the appearance of irregular vascular spaces (asterisk) and loss of retroplacental hypoechoic stripe (arrowheads), which suggested obliteration of the basal decidua. She underwent an emergency cesarean section, which confirmed the abnormal adherence of the placenta to the myometrium. The placenta was left in situ, and a cesarean hysterectomy was performed to decrease the risk of massive hemorrhage. Gross and histopathological examination (Panels B and C) confirmed the diagnosis of placenta increta, with trophoblastic invasion into the myometrium. There is a spectrum of abnormal placentation: placenta accreta refers to the attachment of the chorionic villi to the myometrium, placenta increta to the invasion of the chorionic villi into the myometrium, and placenta percreta to invasion through the myometrium, with or without involvement of surrounding structures. Abnormal placentation may be suspected on ultrasonography or magnetic resonance imaging but can be diagnosed definitively only on histopathological examination. The patient's postoperative course was uncomplicated. She was discharged home with her newborn on the fifth postoperative day, and both mother and child remained well at follow-up 12 months after delivery.

The depletion of MARVELD1 leads to murine placenta accreta via integrin β4‐dependent trophoblast cell invasion

“…Disruption of this tightly controlled process can lead to placental deficiencies, resulting in pregnancy complications (Lash, ) such as early miscarriage (Hustin, Jauniaux, & Schaaps, ), late miscarriage (Ball, Bulmer, Ayis, Lyall, & Robson, ), preeclampsia (Pijnenborg et al, ), fetal growth restriction (Khong, De Wolf, Robertson, & Brosens, ), preterm birth (Kim et al, ), and placenta accreta (Khong & Robertson, ). Placenta accreta is a disorder of human placentation characterized by the abnormal attachment or invasion of placental tissue into the underlying uterine musculature (Dashraath & Lin, ; Jauniaux, Collins, Jurkovic, & Burton, ; Luke, Sharpe, & Greene, ). Despite the importance of trophoblast cell invasion in placenta development, very little is known about the factors that control this process in vivo.…”

The depletion of MARVELD1 leads to placenta accreta via integrin β4-dependent trophoblast cell invasion

“…Disruption of this tightly controlled process can lead to placental deficiencies, resulting in pregnancy complications(Lash, 2015) such as early miscarriage(Hustin et al, 1990), late miscarriage(Ball et al, 2006), preeclampsia(Pijnenborg et al, 1991), fetal growth restriction(Khong et al, 1986), preterm birth(Kim et al, 2003), and placenta accreta(Khong and Robertson, 1987). Placenta accreta is a disorder of human placentation characterized by the abnormal attachment or invasion of placental tissue into the underlying uterine musculature (Dashraath and Lin, 2016; Jauniaux et al, 2016; Luke et al, 1966). Despite the importance of cytotrophoblast cell invasion in placenta development, very little is known about the factors that control this process in vivo.…”