Pathophysiology of Placenta Accreta Spectrum Disorders: A Review of Current Findings.
Accepted version
Peer-reviewed
Repository URI
Repository DOI
Change log
Authors
Jauniaux, Eric
Burton, Graham J
Abstract
Current findings continue to support the concept of a biologically defective decidua rather than a primarily abnormally invasive trophoblast. Prior cesarean sections increase the risk of placenta previa and both adherent and invasive placenta accreta, suggesting that the endometrial/decidual defect following the iatrogenic creation of a uterine myometrium scar has an adverse effect on early implantation. Preferential attachment of the blastocyst to scar tissue facilitates abnormally deep invasion of trophoblastic cells and interactions with the radial and arcuate arteries. Subsequent high velocity maternal arterial inflow into the placenta creates large lacunae, destroying the normal cotyledonary arrangement of the villi.
Description
Keywords
Cesarean Section, Cicatrix, Decidua, Female, Humans, Myometrium, Placenta Accreta, Placenta Previa, Placental Circulation, Pregnancy, Trophoblasts, Ultrasonography, Prenatal, Uterine Artery
Journal Title
Clin Obstet Gynecol
Conference Name
Journal ISSN
0009-9201
1532-5520
1532-5520
Volume Title
61
Publisher
Ovid Technologies (Wolters Kluwer Health)