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The “Great Obstetrical Syndromes” are associated with disorders of deep placentation
Open accessAbstract
Defective deep placentation has been associated with a spectrum of complications of pregnancy including preeclampsia, intrauterine growth restriction, preterm labor, preterm premature rupture of membranes, late spontaneous abortion, and abruptio placentae. The disease of the placental vascular bed that underpins these complications is commonly investigated with targeted biopsies. In this review, we critically evaluate the biopsy technique to summarize the salient types of defective deep placentation, and propose criteria for the classification of defective deep placentation into 3 types based on the degree of restriction of remodeling and the presence of obstructive lesions in the myometrial segment of the spiral arteries.
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“Inadequate placentation is seen in several common obstetrical syn dromes, including fetal growth restriction, spontaneous second trimester miscarriages, placental abruption, preterm birth, and hyper tensive disorders in pregnancy (Brosens et al., 2011).”
From Pregnancy-related maternal physiological adaptations and fetal chemical exposure (2023) · cites this paper as Brosens et al., 2011
In the citing paper
“Failure of trophoblast invasion and arterial remodeling is associated with the 'Great Obstetrical Syndromes', including growth restriction, pre-eclampsia and late spontaneous abortion, due to impaired maternal perfusion (64).”
From Placental Origins of Chronic Disease (2016) · cites this paper as [64]
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Fetal Growth Restriction: Does an Integrated Maternal Hemodynamic-Placental Model Fit Better?
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“More severe FGR occurs in cases of abnormal deep invasion as opposed to decidual [63].”
BackgroundEarly onset preeclampsia in a model for human placental trophoblast
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“4% of pregnancies and often leads to fetal growth restriction (3).”
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Romero, R. J., Jung, E., Chaiworapongsa, T., Erez, O., Gudicha, D. W., Kim, Y. M., Kim, J.-S., Kim, B., Kusanovic, J. P., Gotsch, F., et al. (2022) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2022.04.015 · Cited by 86
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Malaria in Pregnancy: From Placental Infection to Its Abnormal Development and Damage
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“Miscarriage is but one of a number of complications of pregnancy that share a common association with deficient trophoblast proliferation and invasion [106].”
BackgroundPreeclampsia: Linking Placental Ischemia with Maternal Endothelial and Vascular Dysfunction
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New insights into the mechanisms underlying recurrent pregnancy loss
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“Failure of deep placentation, or failure of maternal adaptation to pregnancy, is widely acknowledged to cause the ‘great obstetrical syndromes’, a term that refers to severe obstetrical disorders such as pre-eclampsia, fetal growth restriction and preterm birth.(14) Thus, from an evolutionary perspective, it is clear…”
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Preeclampsia: a defect in decidualization is associated with deficiency of Annexin A2
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Metadata
- Authors
- Brosens, I., Pijnenborg, R., Vercruysse, L., & Romero, R.
- Affiliations
- Leuven Institute for Fertility and Embryology (BE)
- Universitair Ziekenhuis Leuven (BE)
- National Institutes of Health (US)
- Venue
- American Journal of Obstetrics and Gynecology
- Publisher
- Elsevier BV
- Published
- 2011-03
- Volume
- 204
- Issue
- 3
- Pages
- 193-201
- ISSN
- 0002-9378 (ISSN-L)
- PMC
- PMC3369813
- OpenAlex
- W2034492080
- Cited by
- 1,568
- References
- 82
- Citations by year
- 2026: 123 · 2025: 126 · 2024: 128 · 2023: 147 · 2022: 153 · 2021: 155 · 2020: 145 · 2019: 121 · 2018: 91 · 2017: 79 · 2016: 61 · 2015: 69 · 2014: 66 · 2013: 49 · 2012: 30
- FWCI
- 4.99
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- American Journal of Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development
- National Institutes of Health
- U.S. Department of Health and Human Services
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Life Sciences › Immunology and Microbiology › Immunology › Reproductive System and Pregnancy
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Keywords
- great obstetrical syndromes, preeclampsia, fetal growth restriction, preterm labor, preterm premature rupture of membranes, miscarriage, placental abruption, spiral artery remodeling, placental biopsy
- MeSH terms
- Biopsy, Female, Humans, Placenta, Placenta Diseases, Pregnancy, Pregnancy Complications, Syndrome
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