Can immunohistochemistry improve the pathological diagnosis of placenta accreta spectrum (PAS) disorders?

Losi, Lorena; Botticelli, Laura; Mancini, Luciano; Negro, Rosa; Hanspeter, Esther; Dematté, Eva; Grandi, Giovanni; Facchinetti, Fabio; Veneziano, Micaela; Malagoli, Claudia; Masini, Meris; Fabbiani, Luca; Rivasi, Francesco

doi:10.1007/s00404-023-07143-0

Cited by 1 publication

(1 citation statement)

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“…Placenta accreta was first published in 1937 by Irving and Hertig [21]. The term of PAS disorder includes all grades of pregnancy complications due to abnormal placental implantation [22][23][24], which can be histologically classified as placenta accreta, placenta increta, and placenta percreta [25][26][27]. In other words, PAS is defined as a spectrum of abnormal attachment of villous tissue to the uterine wall [28].…”

Section: Definition and Clinical Manifestations Of Pasmentioning

confidence: 99%

Current understanding of the pathogenesis of placenta accreta spectrum disorder with focus on mitochondrial function

Kobayashi,

Matsubara,

Yoshimoto

et al. 2024

J of Obstet and Gynaecol

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AimThe refinement of assisted reproductive technology, including the development of cryopreservation techniques (vitrification) and ovarian stimulation protocols, makes frozen embryo transfer (FET) an alternative to fresh ET and has contributed to the success of assisted reproductive technology. Compared with fresh ET cycles, FET cycles were associated with better in vitro fertilization outcomes; however, the occurrence of pregnancy‐induced hypertension, preeclampsia, and placenta accreta spectrum (PAS) was higher in FET cycles. PAS has been increasing steadily in incidence as a life‐threatening condition along with cesarean rates worldwide. In this review, we summarize the current understanding of the pathogenesis of PAS and discuss future research directions.MethodsA literature search was performed in the PubMed and Google Scholar databases.ResultsRisk factors associated with PAS incidence include a primary defect of the decidua basalis or scar dehiscence, aberrant vascular remodeling, and abnormally invasive trophoblasts, or a combination thereof. Freezing, thawing, and hormone replacement manipulations have been shown to affect multiple cellular pathways, including cell proliferation, invasion, epithelial‐to‐mesenchymal transition (EMT), and mitochondrial function. Molecules involved in abnormal migration and EMT of extravillous trophoblast cells are beginning to be identified in PAS placentas. Many of these molecules were also found to be involved in mitochondrial biogenesis and dynamics.ConclusionThe etiology of PAS may be a multifactorial genesis with intrinsic predisposition (e.g., placental abnormalities) and certain environmental factors (e.g., defective decidua) as triggers for its development. A distinctive feature of this review is its focus on the potential factors linking mitochondrial function to PAS development.

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