Taiwanese Journal of Obstetrics and Gynecology
Volume 45, Issue 2 , Pages 100-106, June 2006

Differential Expression of Growth-, Angiogenesis- and Invasion-Related Factors in The Development of Placenta Accreta

  • Jenn-Jhy Tseng

      Affiliations

    • Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taichung, Taiwan
    • Hung-Kuang University, Taichung, Taiwan
    • Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Jenn-Jhy Tseng, Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, 160, Section 3, Taichung-Kang Road, Taichung 40705, Taiwan
    • ,
  • Min-Min Chou

      Affiliations

    • Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taichung, Taiwan
    • Hung-Kuang University, Taichung, Taiwan
    • Chung-Shan Medical University, Taichung, Taiwan

Accepted 14 February 2006.

Article Outline

Summary

Placenta accreta is the major cause of maternal death complicated by massive peripartum hemorrhage. Its development is traditionally considered to be related to a decidual defect caused by previous cesarean deliveries or uterine curettages. Usually, placental villi firmly adhere to the superficial myometrium and deeply invade, or even penetrate, the uterine wall. Abnormal uteroplacental neovascularization is another characteristic. Therefore, we hypothesized that placenta accreta develops as a result of abnormal expressions of growth-, angiogenesis- and invasion-related factors in trophoblast populations. We have found, in pregnancies complicated by placenta accreta: upregulated epidermal growth factor receptor and downregulated c-erbB-2 oncoprotein in syncytiotrophoblasts; downregulated vasculoendothelial growth factor receptor-2 expression in syncytiotrophoblasts and increased vasculoendothelial growth factor in placental lysates; and downregulated Tie-2 expression in syncytiotrophoblasts and enhanced angiopoietin-2 level in placental lysates. However, matrix metalloproteinase expression was not upregulated, so the association of these invasion-related molecules with placenta accreta is less likely. Taken together, these findings imply that complex factors, either alone or in combination, might be responsible for the development of placenta accreta. Further studies are needed to understand the signaling pathways and possible genetic events.

Key Words:  angiogenesis , growth , invasion , placenta accreta , trophoblast

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PII: S1028-4559(09)60205-9

doi:10.1016/S1028-4559(09)60205-9

Taiwanese Journal of Obstetrics and Gynecology
Volume 45, Issue 2 , Pages 100-106, June 2006

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