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Review
. 2011 Jun;25(3):313-27.
doi: 10.1016/j.bpobgyn.2011.02.006. Epub 2011 Mar 8.

Placental bed disorders in preterm labor, preterm PROM, spontaneous abortion and abruptio placentae

Roberto Romero  1 , Juan Pedro Kusanovic, Tinnakorn Chaiworapongsa, Sonia S Hassan
Affiliations
Review

Placental bed disorders in preterm labor, preterm PROM, spontaneous abortion and abruptio placentae

Roberto Romero et al. Best Pract Res Clin Obstet Gynaecol. 2011 Jun.

Abstract

Failure of physiologic transformation of the spiral arteries has been studied using placental bed biopsies in several obstetrical syndromes. Contrary to what was originally believed, this lesion is not restricted to preeclampsia and/or intrauterine growth restriction. A review of published evidence indicates that failure of physiologic transformation can be observed in women with spontaneous second trimester abortions, preterm labor with intact membranes, preterm prelabor rupture of membranes and abruptio placentae. Therefore, disorders of deep placentation are present in a wide range of complications of pregnancy, emphasizing the importance of understanding the physiology and pathology of transformation of the spiral arteries. We propose that changes in the population and function of immunocytes at the maternal-fetal interface can be part of the mechanism of disease of obstetrical disorders, and this requires further investigation.

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Conflict of interest statement

Conflict of interest: The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Mean percentage on non-transformed spiral arteries weighted by the number of vessels. Figure 1a: The mean percentage of the spiral arteries that had failure of physiologic transformation in the myometrial segment was significantly higher in patients with preterm labor and those with preeclampsia than in normal pregnant women at term (preterm labor; mean ± SEM = 30.9% ± 5.8% vs. normal pregnant women; mean ± SEM = 13.6% ± 2.1%; p=0.0004 and preeclampsia; mean ± SEM = 80.5% ± 3.8% vs. normal pregnant women; mean ± SEM = 13.6% ± 2.1%; p<0.0001). Figure 1b: Patients with preterm labor and intact membranes, as well as patients with preeclampsia, had a significantly higher mean percentage of the spiral arteries that had failure of physiologic transformation in the decidual segment of the placental bed than normal pregnant women (preterm labor; mean ± SEM = 13.1% ± 4.4% vs. normal pregnant women; mean ± SEM = 3.6% ± 1.2%; p=0.001 and preeclampsia; mean ± SEM = 33.1% ± 4.5% vs. normal pregnant women; mean ± SEM = 3.6% ± 1.2%; p<0.0001). Figure 1c: The mean percentage of the spiral arteries that had failure of physiologic transformation in the decidual segments of the basal plate was not significantly different between patients with preterm labor and normal pregnant women at term (preterm labor; mean ± SEM = 10.4% ± 3.0% vs. normal pregnant women; mean ± SEM = 7.4% ± 1.3%; p>0.05). Patients with preeclampsia had a significantly higher mean percentage of the spiral arteries that had failure of physiologic transformation in the decidual segments of the basal plate than patients with preterm labor and normal pregnant women (preeclampsia; mean ± SEM = 38.7% ± 4.0% vs. preterm labor; mean ± SEM = 10.4% ± 3.0%; p<0.0001 and preeclampsia; mean ± SEM = 38.7% ± 4.0% vs. normal pregnant women; mean ± SEM = 7.4% ± 1.3%; p<0.0001). Comparisons were performed with ANOVA, followed by student’s t tests; p value >0.017 became non-significant after adjusting for multiple comparisons.
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References

    1. Khong Y, Brosens I. Defective deep placentation. Best.Pract.Res.Clin.Obstet Gynaecol. 2010 in press. - PubMed
    1. Pijnenborg R, Vercruysse L, Brosens I. Deep placentation. Best.Pract.Res.Clin.Obstet Gynaecol. 2011 in press. - PubMed
    1. Espinoza J, Romero R, Mee KY, Kusanovic JP, Hassan S, Erez O, et al. Normal and abnormal transformation of the spiral arteries during pregnancy. J.Perinat.Med. 2006;34:447–458. - PMC - PubMed
    1. Brosens I, Pijnenborg R, Vercruysse L, Romero R. The "Great Obstetrical Syndromes" are associated with disorders of deep placentation. Am J Obstet Gynecol. 2010 in press. - PMC - PubMed
    1. Khong TY, Liddell HS, Robertson WB. Defective haemochorial placentation as a cause of miscarriage: a preliminary study. Br J Obstet Gynaecol. 1987;94:649–655. - PubMed

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