The modern concepts of etiology and pathogenesis placenta accreta and prospects of its prediction by molecular diagnostics
Objective. To conduct a systematic analysis of the data available in the current literature, risk factors, pathogenesis and markers, determined by laboratory diagnostic methods that indicate a placenta accreta.Vinitskiy A.A., Shmakov R.G.
Subject and methods. The survey includes data of foreign and domestic items found in Pubmed on the subject, published in the last 5 years.
Results. There are the basic molecular mechanisms that lead to placenta accreta. It is described risk factors and laboratory markers that allow to diagnose placenta accreta.
Conclusion. There are many theories that consider the pathogenesis of placenta accrete by many sides. The most common one postulates about the important role of hypoxic factor with reduced vascular component of scar tissue on the uterus. It explains the high prevalence of this disease among women who have a caesarean section that was performed previously. A perspective direction is the prediction and diagnosis of placenta accreta by detecting of laboratory markers: some proteins, fetal DNA, mRNA, thereby complementing the instrumental imaging.
Keywords
placenta accreta
scar on the uterus
cesarean section
the pro-brain natriuretic peptide
fetal DNA
mRNA
microRNA
human chorionic gonadotropin
placental human lactogen
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Received 26.08.2016
Accepted 02.09.2016
About the Authors
Vinitskiy A.A., Postgraduate student of maternity departments, Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia.117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +79253620232. E-mail: drvinitskiy@gmail.com
Shmakov R.G., MD, PhD, the chief medical officer, Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia.
117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954387300. E-mail: r_shmakov@oparina4.ru
For citations: Vinitskiy A.A., Shmakov R.G. The modern concepts of etiology and pathogenesis placenta accreta and prospects of its prediction by molecular diagnostics.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (2): 5-10. (in Russian)
http://dx.doi.org/10.18565/aig.2017.2.5-10
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