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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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“Defective placental implantation into the maternal uterine myometrium characterizes HDP, and intrauterine growth restriction resulting in SGA babies and preterm delivery.(9,10) This abnormal placentation is characterized by adverse vascular remodeling of spiral arteries and presence of pathological obstructive lesions…”
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“Menstrual preconditioning to improve pregnancy outcome As stated, preeclampsia and preterm birth are major obstetric risks in women with PCOS and are characterized by defective deep placentation.(39) It has been shown that insufficient or defective maturation of endometrium and decidual natural killer cells during the…”
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Abnormal Placentation Associated with Infertility as a Marker of Overall Health
Sundheimer, L. W., & Pisarska, M. D. (2017) · Seminars in Reproductive Medicine · doi:10.1055/s-0037-1603570 · Cited by 24
Leite, D. F. B., Morillon, A.-C., Junior, E. F. D. M., Souza, R. T., McCarthy, F. P., Khashan, A. S., Baker, P. N., Kenny, L. C., & Cecatti, J. G. (2019) · BMJ Open · doi:10.1136/bmjopen-2019-031238 · Cited by 21
Pregnancy complications recur independently of maternal vascular malperfusion lesions
Christians, J. K., & Munoz, M. F. H. (2020) · PLoS ONE · doi:10.1371/journal.pone.0228664 · Cited by 22
Whitehead, C. L., Walker, S. P., Lappas, M., & Tong, S. Y. C. (2013) · Journal of Perinatology · doi:10.1038/jp.2013.16 · Cited by 22
Induced Human Decidual NK-Like Cells Improve Utero-Placental Perfusion in Mice
Cavalli, R. D. C., Cerdeira, A. S., Pernicone, E., Korkes, H. A., Burke, S. D., Rajakumar, A., Thadhani, R., Roberts, D. J., Bhasin, M., Karumanchi, S. A., et al. (2016) · PLoS ONE · doi:10.1371/journal.pone.0164353 · Cited by 22
Hong, J., Crawford, K., Cavanagh, E., da Silva Costa, F., & Kumar, S. (2024) · Ultrasound in Obstetrics & Gynecology · doi:10.1002/uog.27513 · Cited by 21
“Histological and imaging evidence of defective placentation 9 is present in placentae from pregnancies complicated by pre-eclampsia 10 , FGR 11 and spontaneous PTB 12 .”
BackgroundProtein Profiling of Preeclampsia Placental Tissues
Shu, C., Liu, Z., Cui, L., Wei, C., Wang, S., Tang, J. J., Cui, M., Lian, G., Li, W., Liu, X., et al. (2014) · PLoS ONE · doi:10.1371/journal.pone.0112890 · Cited by 21
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Association Between Endometriosis Phenotype and Preterm Birth in France
Marcellin, L., Goffinet, F., Azria, É., Thomin, A., Garabédian, C., Sibiude, J., Verspyck, É., Koskas, M., Santulli, P., Rousseau, J., et al. (2022) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.47788 · Cited by 23
BCAM Deficiency May Contribute to Preeclampsia by Suppressing the PIK3R6/p-STAT3 Signaling
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“The hypercoagulation states were shown to be associated with recurrent pregnancy loss, intrauterine fetal growth restriction (IUGR), PE, and venous thromboembolism [39].”
BackgroundRashid, M. R. Z., Lim, J. F., Nawawi, N. H. M., Luqman, M., Zolkeplai, M. F., Rangkuty, H. S., Nor, N. A. M., Tamil, A. M., Shah, S. A., Tham, S. W., et al. (2014) · Gynecological Endocrinology · doi:10.3109/09513590.2013.860960 · Cited by 21
Gyselaers, W., & Peeters, L. L. H. (2013) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.3109/14767058.2013.766705 · Cited by 21
LIMK1 Regulates Human Trophoblast Invasion/Differentiation and Is Down-Regulated in Preeclampsia
Zhou, Y., Yuge, A., Rajah, A. M., Ünek, G., Rinaudo, P. F., & Maltepe, E. (2014) · American Journal Of Pathology · doi:10.1016/j.ajpath.2014.08.013 · Cited by 22
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UNIVERSIDAD NACIONAL DE LA AMAZONÍA PERUANA
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Triunfo, S., Crovetto, F., Crispi, F., Rodríguez‐Sureda, V., Domı́nguez, C., Nadal, A., Peguero, A., Gratacós, E., & Figueras, F. (2016) · Placenta · doi:10.1016/j.placenta.2016.04.005 · Cited by 21
The perplexing pregnancy disorder preeclampsia: what next?
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Hitzerd, E., Broekhuizen, M., Neuman, R. I., Colafella, K. M. M., Merkus, D., Schoenmakers, S., Simons, S. H. P., Reiss, I. K. M., & Danser, A. H. J. (2019) · Current Pharmaceutical Design · doi:10.2174/1381612825666190405145228 · Cited by 21
The BMP2 Signaling Axis Promotes Invasive Differentiation of Human Trophoblasts
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“Aberrant trophoblast (EVT or syncytiotrophoblast) differentiation or improper trophoblast invasion may lead to various unfavorable pregnancy-related outcomes, including early pregnancy loss (EPL), preeclampsia, intrauterine growth restriction, and choriocarcinoma (Brosens et al., 2011).”
BackgroundIqbal, K., Pierce, S. H., Kozai, K., Dhakal, P., Scott, R. L., Roby, K. F., Vyhlidal, C. A., & Soares, M. J. (2021) · Environmental Health Perspectives · doi:10.1289/ehp9256 · Cited by 20
“Pregnancy-related diseases such as pre-eclampsia, intrauterine growth restriction, and preterm birth are associated with dysfunctional placentation, especially failures in endovascular trophoblast cell invasion and uterine spiral artery remodeling (Brosens et al. 2011, 2019).”
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Štafl, K., Trávníček, M., Janovská, A., Kučerová, D., Pecnová, Ľ., Yang, Z., Stepanec, V., Jech, L., Salker, M. S., Hejnar, J., et al. (2024) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2407519121 · Cited by 24
Uterine artery impedance at very early clinical pregnancy
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Souza, R. T., Cecatti, J. G., Mayrink, J., Galvão, R. B., Costa, M. L., Feitosa, F. E. D. L., Filho, E. A. R., Leite, D. F. B., Vettorazzi, J., Tedesco, R. P., et al. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-023101 · Cited by 20
“Preterm birth and pre-eclampsia are two important pregnancy complications that have a relatively long subclinical phase before the appearance of signs or symptoms.(8) 9 It is plausible that during subclinical phases of certain conditions the pattern of physical activity (PA) or sleep–wake rhythm is affected in some wa…”
TAGLN2-Regulated Trophoblast Migration, Invasion and Fusion are Impaired in Preeclampsia
Wang, H., Zhang, X., Liu, C., Chen, S., Liu, X., & Fan, S. (2022) · Frontiers in Cell and Developmental Biology · doi:10.3389/fcell.2022.810633 · Cited by 20
“The invasion of shallow CTBs and insufficient repair of the spiral artery are markers of early-onset PE (Brosens et al., 2011).”
Background
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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