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Abnormal invasion of the placenta

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https://read.qxmd.com/read/30755315/methotrexate-infusion-followed-by-uterine-artery-embolisation-for-the-management-of-placental-adhesive-disorders-a-case-series
#1
M R Babaei, M Oveysi Kian, Z Naderi, S Khodaverdi, Z Raoofi, F Javanmanesh, I Mohseni, S Nasiripour, M Farasatinasab
AIM: To evaluate the efficacy and safety of the uterine artery embolisation (UAE) in combination with methotrexate (MTX) for conservative management of placental adhesive disorders. MATERIAL AND METHODS: Patients with placental adhesive disorders (including accreta, increta, and percreta lesions) that were treated with UAE in combination with MTX were identified and were followed prospectively for outcomes including uterine preservation and complications. RESULTS: Twenty-six patients were identified who had the diagnosis of abnormal placenta implantation during this study...
February 9, 2019: Clinical Radiology
https://read.qxmd.com/read/30703717/placental-mesenchymal-dysplasia-an-underdiagnosed-placental-pathology-with-various-clinical-outcomes
#2
Cécile Guenot, John Kingdom, Maud De Rham, Maria Osterheld, Sarah Keating, Yvan Vial, Tim Van Mieghem, Nicole Jastrow, Luigi Raio, Marialuigia Spinelli, Letizia Di Meglio, Gihad Chalouhi, David Baud
BACKGROUND: Placental mesenchymal dysplasia (PMD) is a rare vascular and connective placental anomaly, which is often associated with severe fetal and/or maternal complications. The diversity of presentation of PMD challenges diagnosis and effective pregnancy management. OBJECTIVE: We aimed to review cases presenting at 7 tertiary centers worldwide over the last decade and to study the occurrence of obstetric and neonatal complications. STUDY DESIGN: Pathology databases from 7 tertiary hospitals were screened for cases of PMD (between 2007-2017)...
January 17, 2019: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://read.qxmd.com/read/30666717/detection-of-21q11-2-q22-11-deletions-in-a-fetus-by-nipt
#3
Yunyun Zheng, Biliang Chen, Shanning Wan, Hui Xu, Yinghui Dang, Tingting Song, Yu Li, Jianfang Zhang
BACKGROUND: Non-invasive prenatal testing (NIPT) is extensively used in the detection of fetal trisomies 21, 18, and 13, which is promptly becoming a common clinical practice. Concerned about the clinical application of non-invasive detection of the fetal autosomal duplications or deletion. CASE PRESENTATION: A 34-year-old, healthy pregnant woman was referred to the First Affiliated Hospital of the Air Force Medical University. The ultrasound examination indicates that low-lying placenta, the fetus has a left ventricular bright spot and small amount of pericardial effusion...
January 21, 2019: Journal of Clinical Laboratory Analysis
https://read.qxmd.com/read/30617930/nlrp7-is-increased-in-human-idiopathic-fetal-growth-restriction-and-plays-a-critical-role-in-trophoblast-differentiation
#4
R Abi Nahed, D Reynaud, A J Borg, W Traboulsi, A Wetzel, V Sapin, S Brouillet, M N Dieudonné, M Dakouane-Giudicelli, M Benharouga, P Murthi, Nadia Alfaidy
Fetal growth restriction (FGR) the leading cause of perinatal mortality and morbidity is highly related to abnormal placental development, and placentas from FGR pregnancies are often characterized by increased inflammation. However, the mechanisms of FGR-associated inflammation are far from being understood. NLRP7, a member of a family of receptors involved in the innate immune responses, has been shown to be associated with gestational trophoblastic diseases. Here, we characterized the expression and the functional role of NLRP7 in the placenta and investigated its involvement in the pathogenesis of FGR...
January 8, 2019: Journal of Molecular Medicine: Official Organ of the "Gesellschaft Deutscher Naturforscher und Ärzte"
https://read.qxmd.com/read/30607590/modified-cesarean-hysterectomy-technique-for-management-of-cases-of-placenta-increta-and-percreta-at-a-tertiary-referral-hospital-in-egypt
#5
Ahmed M Hussein, Ahmed Kamel, Ayman Raslan, Dina M R Dakhly, Ali Abdelhafeez, Mohamed Nabil, Mohamed Momtaz
PURPOSE: To evaluate the effect of a modified type II radical hysterectomy on maternal morbidities and mortality in cases with abnormally invasive placenta (AIP). METHODS: 63 cases with AIP were managed at one of the largest referral centers in Egypt in a prospective study design. This technique entails devascularization of the uterus laterally on both sides and to clamp the uterus at the lowest possible point just below the level of the placenta while sparing the ureters...
January 4, 2019: Archives of Gynecology and Obstetrics
https://read.qxmd.com/read/30587375/microrna-423-5p-inhibits-the-progression-of-trophoblast-cells-via-targeting-igf2bp1
#6
Li Guo, Yu Liu, Ying Guo, Yongkang Yang, Biliang Chen
INTRODUCTION: Preeclampsia (PE) is one of the leading causes of maternal and fetal mortality globally. The imbalance of trophoblast homeostasis is closely linked with the pathogenesis of PE. MicroRNA-423-5p (miR-423-5p) has been reported to be abnormally expressed in placenta and blood plasma of pregnant women with PE. In the present study, miR-423-5p expression in blood plasma of pregnant women with PE and healthy pregnant women was detected. Also, the roles and molecular mechanisms of miR-423-5p in the development of trophoblast cells were further investigated...
December 7, 2018: Placenta
https://read.qxmd.com/read/30584683/sono-histological-findings-of-the-placenta-accreta-spectrum
#7
Junichi Hasegawa, Akiko Kurasaki, Toshiyuki Hata, Chika Honma, Ayako Miura, Haruhiro Kondo, Nao Suzuki
Placenta accreta spectrum (PAS) is a complex obstetric complication associated with high maternal morbidity. Several prenatal ultrasound signs of PAS were reported: mainly the disappearance of the normal uteroplacental interface (clear zone), extreme thinning of the underlying myometrium, and vascular changes within the placenta (lacunae) and placental bed (hypervascularity).1, 2 The ability of the ultrasound to detect PAS is dependent upon several factors, such as operator experience, gestational age at assessment, number of abnormal ultrasound findings, and actual degree of placental invasion...
December 24, 2018: Ultrasound in Obstetrics & Gynecology
https://read.qxmd.com/read/30580441/reply-to-abnormally-invasive-placentation-in-cohort-studies-refining-the-methodology
#8
Kristina Martimucci, Jesus R Alvarez-Perez
Thank you for your comments on our manuscript (1). In the letter by Levin et al (2), he wrote that a well designed study should include a large sample size to achieve a high enough power referencing Eshkoli et al (3). This paper has an n=139 as the study group which included cases of clinically diagnosed placenta accreta, and an n=34,000+ which included all the cesarean deliveries during that time period that were not associated with placenta accreta. This paper sought to evaluate risk factors for placenta accreta and found that placenta previa is an independent risk factor...
December 23, 2018: Acta Obstetricia et Gynecologica Scandinavica
https://read.qxmd.com/read/30578147/abnormal-placentation
#9
REVIEW
Whitney Booker, Leslie Moroz
The term "morbidly adherent placenta" has recently been introduced to describe the spectrum of disorders including placenta accreta, increta and percreta. Due to excessive invasion of the placenta into the uterus there is associated significant maternal morbidity and mortality. Most significant risk factors for morbidly adherent placenta include history of prior cesarean delivery as well as placenta previa in the current pregnancy. Ultrasound remains the gold standard for antenatal diagnosis, however, in recent years MRI has assisted in identifying complex parametrial involvement...
November 15, 2018: Seminars in Perinatology
https://read.qxmd.com/read/30575983/long-non-coding-rna-tug1-regulates-the-migration-and-invasion-of-trophoblast-like-cells-through-sponging-mir-204-5p
#10
Yang Yu, Leilei Wang, Man Gao, Hongbo Guan
Preeclampsia (PE) is a leading cause of maternal and perinatal death. Accumulated evidence suggests that many long non-coding RNAs (lncRNAs) abnormally expressed in placentas from PE patients, and they may play functional roles in the development of PE. The present study aimed to investigate the functional role TUG1 in PE and explore the potential molecular mechanisms. Clinically, the expression of TUG1 in placental tissues from PE and normal controls were determined. In vitro, human trophoblast HTR-8/SVneo and JAR cells were employed for loss or gain-of-function assays...
December 21, 2018: Clinical and Experimental Pharmacology & Physiology
https://read.qxmd.com/read/30565213/the-multidisciplinary-management-of-placenta-accreta-spectrum-pas-within-a-single-tertiary-centre-a-ten-year-experience
#11
Nooraishah Yasin, Laura Slade, Elinor Atkinson, Sue Kennedy-Andrews, Steven Scroggs, Rosalie Grivell
INTRODUCTION: Placenta accreta spectrum (PAS) covers a spectrum of placental adherence abnormalities: placenta accreta, increta and percreta. PAS is associated with significant maternal morbidity and mortality. Studies have shown the importance of multidisciplinary teamwork in the management of PAS. AIM: This study was designed to describe the maternal and neonatal morbidity and mortality associated with PAS in our centre over a ten-year period. METHODS: A retrospective cohort study was conducted of pregnancies complicated by PAS between February 2006 and January 2016 at Flinders Medical Centre (FMC), South Australia...
December 18, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://read.qxmd.com/read/30486702/the-role-of-supracervical-hysterectomy-in-reducing-blood-products-requirement-in-the-management-of-placenta-accreta-a-case-control-study
#12
Levin Gabriel, Rottenstreich Amihai, Benshushan Avi, Dior Uri, Shveiky David, Shushan Asher, Elchalal Uriel
OBJECTIVE: While surgical management is the treatment of choice for abnormally invasive placenta, the role of supracervical hysterectomy in this setting is not well established. We aimed to compare supracervical versus total cesarean hysterectomy as a surgical option for abnormally invasive placenta. METHODS: We carried out a 8-year retrospective case-control study. Six cases of patient treated by total hysterectomy were matched and compared to 30 controls treated by supracervical hysterectomy...
November 28, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://read.qxmd.com/read/30486701/blunt-dissection-technique-with-finger-and-vessel-skeletonization-in-the-posterior-vesical-wall-for-abnormally-invasive-placenta-previa
#13
Hüseyin Çağlayan Özcan, Mete Gurol Uğur, Seyhun Sucu, Özcan Balat
PURPOSE: This study described a new technique to minimize the bleeding resulted from aberrant engorged vessels and unintended bladder injury in cases with abnormally invaded placenta adjacent to posterior bladder wall at cesarean hysterectomy. METHODS: After filling the bladder with 300 ml saline aberrant engorged vessels were identified and skeletonized between lower uterine segment and bladder with blunt dissection by index finger down to the distal end point of cervix...
November 28, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://read.qxmd.com/read/30486635/updates-on-the-management-of-placenta-accreta-spectrum
#14
Daniele Di Mascio, Giuseppe Calì, Francesco D'antonio
Placenta accreta spectrum (PAS) disorders is a multifactorial process that encompasses a heterogeneous group of conditions characterized by an abnormal invasion of trophoblastic tissue through the myometrium and uterine serosa. PAS is associated with a high burden of adverse maternal outcomes including severe life-threatening hemorrhage, need for blood transfusion, damage to adjacent organs, and death. Prenatal screening of PAS is mandatory so that women may be counselled about the severity of this condition to plan management with a multidisciplinary team and delivery in a specialized center...
November 27, 2018: Minerva Ginecologica
https://read.qxmd.com/read/30469429/prophylactic-transcatheter-arterial-embolization-helps-intraoperative-hemorrhagic-control-for-removing-invasive-placenta
#15
Kun-Long Huang, Ching-Chang Tsai, Hung-Chun Fu, Hsin-Hsin Cheng, Yun-Ju Lai, Hsuan-Ning Hung, Leo Leung-Chit Tsang, Te-Yao Hsu
OBJECTIVES: The purpose of this article is to investigate the estimated blood loss in pregnant women undergoing cesarean section and placental extirpation to treat abnormal placentation and compare the outcomes of those who underwent prophylactic transcatheter arterial embolization (TAE) with those who did not. METHODS: A retrospective study was conducted on 17 pregnant women diagnosed with abnormal placentation in 2001⁻2018 in a single tertiary center. The patients were diagnosed by surgical finding, ultrasound, or magnetic resonance imaging (MRI)...
November 21, 2018: Journal of Clinical Medicine
https://read.qxmd.com/read/30462321/hezeb2-a-master-regulator-of-the-epithelial-mesenchymal-transition-mediates-trophoblast-differentiation
#16
Sonia DaSilva-Arnold, Che-Ying Kuo, Viralkumar Davra, Yvonne Remache, Peter C W Kim, John P Fisher, Stacy Zamudio, Abdulla Al-Khan, Raymond B Birge, Nicholas P Illsley
STUDY QUESTION: Does the upregulation of the zinc finger E-box binding homeobox 2 (ZEB2) transcription factor in human trophoblast cells lead to alterations in gene expression consistent with an epithelial-mesenchymal transition (EMT) and a consequent increase in invasiveness? SUMMARY ANSWER: Overexpression of ZEB2 results in an epithelial-mesenchymal shift in gene expression accompanied by a substantial increase in invasive capacity of human trophoblast cells. WHAT IS KNOWN ALREADY: In-vivo results have shown that cytotrophoblast differentiation into extravillous trophoblast involves an epithelial-mesenchymal transition...
November 21, 2018: Molecular Human Reproduction
https://read.qxmd.com/read/30457231/-comparison-of-two-approaches-for-placenta-accreta-uterine-preservation-versus-cesarean-hysterectomy
#17
Shlomit Maymon, Ron Maymon, Jacob Bornstein, Josef Tovbin, Yaakov Melcer, Maya Frank Wolf
AIMS: To compare the maternal and newborn outcome between cases that underwent conservative surgery with uterine preservation (Group A) to cesarean hysterectomy (Group B). BACKGROUND: Placenta accreta defines abnormally adherent and invasive placentation into the myometrium and in some cases invades adjacent organs. In recent years the incidence of placenta accreta cases has risen due to the increasing prevalence of cesarean delivery. The clinical manifestation of placenta accreta might be life threatening maternal bleeding during the attempt to detach the placenta following delivery...
November 2018: Harefuah
https://read.qxmd.com/read/30448828/clinical-and-ultrasound-predictors-of-placenta-accreta-in-pregnant-women-with-antepartum-diagnosis-of-placenta-previa-a-multicenter-study
#18
Davide De Vita, Giampiero Capobianco, Giovanni Gerosolima, Carmen Sciorio, Ermenegilda Coppola, Fabio Parazzini, Maurizio Silvestri, Anna Paola Caruso, Maddalena Morlando, Raffaele Petta, Alessandro Pascarella, Salvatore Dessole, Elsa Viora
BACKGROUND/AIMS: Abnormally invasive placenta (AIP) includes placenta accreta, increta, and percreta and represents major complications of pregnancy. This study was designed to assess the role of ultrasonography in the identification of AIP among pregnant women with antepartum diagnosis of placenta previa. METHODS: A cross-sectional study was performed between May 2015 and April 2016 in 11 centers, including 242 women with antepartum diagnosis of placenta previa...
November 16, 2018: Gynecologic and Obstetric Investigation
https://read.qxmd.com/read/30416283/comments-on-manuscript-intrauterine-inflated-foley-s-catheter-balloon-in-the-management-of-abnormally-invasive-placenta-previa-a-case-control-study
#19
Ahmed M Abbas
No abstract text is available yet for this article.
December 2018: Journal of Obstetrics and Gynaecology of India
https://read.qxmd.com/read/30405926/conservative-management-of-abnormally-invasive-placenta-previa-after-midtrimester-foetal-demise
#20
A MacGibbon, Y M Ius
We present the case of a midtrimester intrauterine foetal demise (IUFD) in the context of abnormally invasive placentation. This was a grade 4 placenta previa with placenta increta in a patient requesting fertility conservation and was managed conservatively without immediate surgical intervention. The patient spontaneously delivered the fetus after 33 days, followed by a large obstetric haemorrhage requiring immediate laparotomy and hysterotomy. Her uterus was preserved and she went on to recover without further significant complication...
2018: Case Reports in Obstetrics and Gynecology
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