Placental Pathologic Associations with Morbidly Adherent Placenta: Potential insights into Pathogenesis

Ernst, Linda M.; Linn, Rebecca L.; Minturn, Lucy; Miller, Emily S.

doi:10.2350/16-03-1789-oa.1

Cited by 19 publications

(49 citation statements)

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“…(27) Additionally, the panel felt that evidence for other features commonly seen in the setting of accreta was not sufficient for use as the sole criterion for diagnosis. Most cases of PAS will show overlapping features of tissue injury with degenerated or shriveled myofibers, interstitial edema and chronic inflammation, (2,28,29) [https://slide-atlas.org/link/opzzzv] 3. PAS with more extensive tissue destruction.…”

Section: Gross Featuresmentioning

confidence: 99%

Classification and reporting guidelines for the pathology diagnosis of placenta accreta spectrum (PAS) disorders: recommendations from an expert panel

et al. 2020

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The terminology and diagnostic criteria presently used by pathologists to report invasive placentation is inconsistent and does not reflect current knowledge of the pathogenesis of the disease or the needs of the clinical care team. A consensus panel was convened to recommend terminology and reporting elements unified across the spectrum of PAS specimens (i.e. delivered placenta, total or partial hysterectomy with or without extrauterine tissues, curetting for retained products of conception). The proposed nomenclature under the umbrella diagnosis of Placenta Accreta Spectrum (PAS) replaces the traditional categorical terminology (placenta accreta, increta, percreta) with a descriptive grading system that parallels the guidelines endorsed by the International Federation of Gynaecology and Obstetrics (FIGO). In addition, the nomenclature for hysterectomy specimens is separated from that for delivered placentas. The goal for each element in the system of nomenclature was to provide diagnostic criteria and guidelines for expected use in clinical practice.

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Section: Gross Featuresmentioning

confidence: 99%

Classification and reporting guidelines for the pathology diagnosis of placenta accreta spectrum (PAS) disorders: recommendations from an expert panel

et al. 2020

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“…The significance of leukocyte subpopulations and their contribution to excessive invasion of extravillous trophoblasts (EVT) in PAS requires further investigation; however, initial studies are intriguing. Ernst et al demonstrated an increased lymphocytic infiltrate at the implantation site in a series of 101 PAS specimens compared to patients with placentas sent for examination due to a history of maternal malignancy with no clinical suspicion of PAS [ 32 ].…”

Section: Molecular Biologymentioning

confidence: 99%

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

et al. 2018

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Background. Placenta accreta spectrum (PAS) is a condition of abnormal placental invasion encompassing placenta accreta, increta, and percreta and is a major cause of severe maternal morbidity and mortality. The diagnosis of a PAS is made on the basis of histopathologic examination and characterised by an absence of decidua and chorionic villi are seen to directly adjacent to myometrial fibres. The underlying molecular biology of PAS is a complex process that requires further research; for ease, we have divided these processes into angiogenesis, proliferation, and inflammation/invasion. A number of diagnostic serum biomarkers have been investigated in PAS, including human chorionic gonadotropin (HCG), pregnancy-associated plasma protein-A (PAPP-A), and alpha-fetoprotein (AFP). They have shown variable reliability and variability of measurement depending on gestational age at sampling. At present, a sensitive serum biomarker for invasive placentation remains elusive. In summary, there are a limited number of studies that have contributed to our understanding of the molecular biology of PAS, and additional biomarkers are needed to aid diagnosis and disease stratification.

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“…Other histological findings which were significantly more frequently seen in morbidly adherent placentas when compared to controls include basal chronic villitis, chronic lymphoplasmacytic inflammation in the basal plate, villous agglutination, remote retromembranous hemorrhage, subchorionic intervillous thrombi , and chorionic villi extending into myometrial vascular spaces in postpartum hysterectomies. Morbidly adherent placenta is a frequent cause of postpartum hemorrhage, delayed separation or retained placenta, which is defined clinically as placenta expulsion at least 30 minutes after the delivery of the newborn .…”

Section: Types Of Abnormal Placentationmentioning

confidence: 98%

Abnormalities of placenta implantation

Castro

Popek

2018

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Placental Pathologic Associations with Morbidly Adherent Placenta: Potential insights into Pathogenesis

Abstract: MAP is highly associated with evidence of intraparenchymal placental hemorrhage villous changes of MVU, and a lymphoplasmacytic infiltrate at the implantation site. The contribution of this basal chronic inflammatory infiltrate to MAP requires further investigation.

Cited by 19 publications

References 0 publications

Classification and reporting guidelines for the pathology diagnosis of placenta accreta spectrum (PAS) disorders: recommendations from an expert panel

Classification and reporting guidelines for the pathology diagnosis of placenta accreta spectrum (PAS) disorders: recommendations from an expert panel

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

Abnormalities of placenta implantation

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