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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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“These pregnancy complications may share underlying causes, as formulated in the concepts of great obstet-rical syndromes 14,15,33 or ischemic placental disease.”
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“In normal pregnancies, the invasion of the decidua starts from 8 to 18 weeks [3, 4].”
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Self-citationPhysiopathologie de la pré-éclampsie
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Mattila, M., Kemppainen, H., Isoniemi, H., & Polo‐Kantola, P. (2017) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1111/aogs.13175 · Cited by 16
Can Placental Histopathology Lesions Predict Recurrence of Small for Gestational Age Neonates?
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“Abnormal deep placentation has been associated with a spectrum of pregnancy complications including preeclampsia, intrauterine growth restriction, preterm labor, preterm premature rupture of membranes, late spontaneous abortion, and placental abruption.(27) The disease of the placental vascular bed that underpins thes…”
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Pre-conception blood pressure and evidence of placental malperfusion
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Immunoglobulin E levels and pregnancy-induced hypertension: Japan Environment and Children’s Study
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“Impaired uteroplacental circulation is closely related to placental dysfunction and plays a central role in the pathogenesis of neonatal complications, such as preterm delivery, PE and foetal growth restriction [7, 8, 24, 25], which may increase the risk of stillbirth [1, 2].”
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Adenomyosis and endometriosis have a common origin
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Self-citationT2* weighted placental MRI in relation to placental histology and birth weight
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“…health is therefore critical for pregnancy success, with defective placentation representing a central mechanism underlying the “great obstetrical syndromes,” including preeclampsia (PE), intrauterine growth restriction (IUGR), placenta accreta spectrum (PAS), preterm birth, and stillbirth [2,3].”
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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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