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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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Lokki, A. I., Haapio, M., & Heikkinen‐Eloranta, J. (2020) · Frontiers in Immunology · doi:10.3389/fimmu.2020.00548 · Cited by 35
The use of elastography in placental research – A literature review
Edwards, C. R., Cavanagh, E., Kumar, S., Clifton, V. L., & Fontanarosa, D. (2020) · Placenta · doi:10.1016/j.placenta.2020.07.014 · Cited by 35
Kim, M., Adu‐Gyamfi, E. A., Kim, J., & Lee, B. (2023) · Nucleic Acids Research · doi:10.1093/nar/gkad215 · Cited by 35
“Abnormal trophoblast differentiation is closely linked to placenta-related disorders, including stillbirth, miscarriage, intrauterine fetal growth restriction (IUGR) and pre-eclampsia (PE) (3).”
BackgroundPuttemans, P., Benagiano, G., Gargett, C. E., Romero, R. J., Guo, S., & Brosens, I. (2016) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.1080/14767058.2016.1216540 · Cited by 35
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Medical and ethical considerations in uterus transplantation
Benagiano, G., Landeweerd, L., & Brosens, I. A. (2013) · International Journal of Gynecology & Obstetrics · doi:10.1016/j.ijgo.2013.05.010 · Cited by 34
Self-citationHong, J. G. S., & Kumar, S. (2023) · Clinical Science · doi:10.1042/cs20220300 · Cited by 39
Preeclampsia and the Antiphospholipid Syndrome
Mayer-Pickel, K. I., Nanda, M., Gajić, M., & Cervar-Zivkovic, M. (2023) · Biomedicines · doi:10.3390/biomedicines11082298 · Cited by 33
“In EOP, mainly the defective remodeling of the uterine spiral arteries is responsible for the uteroplacental malperfusion [56].”
BackgroundImmunologic aspects of preeclampsia
Boulanger, H., Bounan, S., Mahdhi, A., Drouin, D., Ahriz-Saksi, S., Guimiot, F., & Rouas‐Freiss, N. (2024) · AJOG Global Reports · doi:10.1016/j.xagr.2024.100321 · Cited by 35
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“3,24 Due to the naturally low abundance of CTT/EVT, enrichment of HLA-G pos cells to obtain a higher yield is commonly used to study invasion.”
Uterine artery Doppler evaluation in twin pregnancies at 11 + 0 to 13 + 6 weeks of gestation
Rizzo, G., Pietrolucci, M. E., Aiello, E., Capponi, A., & Arduini, D. (2014) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.13340 · Cited by 34
The Role of Statins in Prevention of Preeclampsia: A Promise for the Future?
Katsi, V. K., Georgountzos, G., Kallistratos, M. S., Zerdes, I., Makris, T. K., Manolis, A. J., Nihoyannopoulos, P., & Tousoulis, D. (2017) · Frontiers in Pharmacology · doi:10.3389/fphar.2017.00247 · Cited by 34
Vokálová, L., van Breda, S. V., Ye, X. L., Huhn, E. A., Than, N. G., Hasler, P., Lapaire, O., Hoesli, I. M., Rossi, S. W., & Hahn, S. (2018) · Frontiers in Endocrinology · doi:10.3389/fendo.2018.00542 · Cited by 35
Salpingitis Impairs Bovine Tubal Function and Sperm-Oviduct Interaction
Owhor, L. E., Reese, S., & Kölle, S. (2019) · Scientific Reports · doi:10.1038/s41598-019-47431-x · Cited by 34
MicroRNAs isolated from peripheral blood in the first trimester predict spontaneous preterm birth
Winger, E. E., Reed, J. L., Ji, X., Gomez‐Lopez, N., Pacora, P., & Romero, R. J. (2020) · PLoS ONE · doi:10.1371/journal.pone.0236805 · Cited by 36
Self-citationStráník, J., Kacerovský, M., Andrýs, C., Souček, O., Bolehovská, R., Holečková, M., Matulová, J., Jacobsson, B., & Musilova, I. K. (2021) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.1080/14767058.2020.1869932 · Cited by 34
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Implication du stress oxydant dans la physiopathologie de la pré-éclampsie : mise au point
Guerby, P., Vidal, F., Garoby-Salom, S., Vayssière, C., Salvayre, R., Parant, O., & Nègre‐Salvayre, A. (2015) · Gynécologie Obstétrique & Fertilité · doi:10.1016/j.gyobfe.2015.09.011 · Cited by 34
Maternal Serum α-Fetoprotein at 11–13 Weeks’ Gestation in Spontaneous Early Preterm Delivery
Beta, J., Bredaki, F. E., Calvo, J. R., Akolekar, R., & Nicolaides, K. H. (2011) · Fetal Diagnosis and Therapy · doi:10.1159/000324352 · Cited by 33
Uteroplacental Doppler flow and pregnancy outcome in women with tetralogy of Fallot
Kampman, M. A. M., Siegmund, A. S., Bilardo, C. M., van Veldhuisen, D. J., Balci, A., Oudijk, M. A., Groen, H., Mulder, B. J. M., Roos‐Hesselink, J. W., Sieswerda, G. T., et al. (2016) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.15938 · Cited by 33
Miscarriage syndrome: Linking early pregnancy loss to obstetric and age-related disorders
Bortoletto, P. E., Lucas, E. S., Melo, P., Gallos, I. D., Devall, A., Bourne, T., Quenby, S. M., Bennett, P. R., Coomarasamy, A., & Brosens, J. J. (2022) · EBioMedicine · doi:10.1016/j.ebiom.2022.104134 · Cited by 33
Conservation at the uterine–placental interface
Scott, R. L., Vu, H., Jain, A., Iqbal, K., Tuteja, G., & Soares, M. J. (2022) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2210633119 · Cited by 33
“Impairments in trophoblast72 directed uterine transformation are linked to pregnancy-related diseases (2, 3, 8).”
BackgroundAssociations of maternal and placental extracellular vesicle miRNA with preeclampsia
Aharon, A., Rebibo-Sabbah, A., Ahmad, R. S., Dangot, A., Bar-Lev, T. H., Brenner, B., Halberthal-Cohen, A., David, C. B., Weiner, Z., & Solt, I. (2023) · Frontiers in Cell and Developmental Biology · doi:10.3389/fcell.2023.1080419 · Cited by 33
“It may be inferred that trophoblast EVs did not reflect the same expression as placental sections and the source of the decreased miRNA EVs in GVCs is primarily related to maternal pathology.”
BackgroundInfluentialAGEs, contributors to placental bed vascular changes leading to preeclampsia
Guedes‐Martins, L., Matos, L., Soares, A., Silva, E., & Almeida, H. (2013) · Free Radical Research · doi:10.3109/10715762.2013.815347 · Cited by 38
Pregnancy-related maternal physiological adaptations and fetal chemical exposure
Vinnars, M.-T., Bixo, M., & Damdimopoulou, P. (2023) · Molecular and Cellular Endocrinology · doi:10.1016/j.mce.2023.112064 · Cited by 32
“Inadequate placentation is seen in several common obstetrical syndromes, including fetal 445 growth restriction, spontaneous second trimester miscarriages, placental abruption, preterm 446 birth, and hypertensive disorders in pregnancy [81].”
BackgroundDoppler evaluation of normal and abnormal placenta
Hernandez‐Andrade, E. A., Huntley, E. S., Bartal, M. F., Soto‐Torres, E. E., Tirosh, D., Jaiman, S., & Johnson, A. (2021) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.24816 · Cited by 32
Sovio, U., Gaccioli, F., Cook, E., Jones, D. S., & Smith, G. C. S. (2023) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.17691 · Cited by 35
“This is consistent with the view that the major complications of pregnancy, sometimes referred to as the Great Obstetrical Syndromes, 16 have shared pathophysiological pathways in disordered placentation.”
ResultRevolutionizing the female reproductive system research using microfluidic chip platform
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“These complications stem from placental dysfunction caused by the inadequate invasion and transformation of uterine arteries by placental extravillous trophoblast cells [251].”
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“Laas et al. also found out a significant association of SPTB in newborns with CHD.22 A possible role of placental dysfunction has been proposed in the explanation of SPTB.23 The lack of physiological transformation of spiral uterine arteries was found in the placentas and in the uterine placental bed biopsies of women…”
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“It is thought that subsequent pregnancies reduce the occurrence of PE because of higher implantation or placentation [22] and enhanced maternal cardiovascular adaptation [23–25] by increased end-diastolic blood volume, stroke volume, and decreased vascular resistance [24], resulting in decreased mean arterial pressure…”
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“FGR is usually related to placental insufficiency and may present in association with other prevalent complications of pregnancy, mainly prematurity and preeclampsia [2].”
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Immunobiology of pregnancy: from basic science to translational medicine
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Protein O-GlcNAcylation Promotes Trophoblast Differentiation at Implantation
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“Understanding implantation as a sensitive developmental window could lead to insights into treatments to improve ART success rates, but also to a better understanding of the great obstetric syndromes that are underpinned by placental dysfunction [63].”
BackgroundUterine natural killer cell biology and role in early pregnancy establishment and outcomes
Kanter, J. R., Mani, S. R., Gordon, S. M., & Mainigi, M. A. (2021) · F&S Reviews · doi:10.1016/j.xfnr.2021.06.002 · Cited by 30
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Self-citation
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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