ArticleActa obstetricia et gynecologica Scandinavica2022
Extravillous trophoblast invasion and decidualization in cesarean scar pregnancies.
Article in Acta obstetricia et gynecologica Scandinavica, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 17 citations in OpenAlex.
- The molecular pathogenesis of placenta accreta spectrum disorder and its clinical applications.Archives of gynecology and obstetrics · 2025Review
- Dysregulation of decidual NK cell proliferation by impaired decidual cells: a potential contributor to excessive trophoblast invasion in placenta accreta spectrum.Frontiers in cell and developmental biology · 2025Article
- Exaggerated placental site in a cesarean scar: Misdiagnosed as gestational trophoblastic neoplasia: A case report.Experimental and therapeutic medicine · 2024Article
- Appendiceal perforation secondary to endometriosis with intestinal metaplasia: A case report.Experimental and therapeutic medicine · 2023Article
- Animal models of the placenta accreta spectrum: current status and further perspectives.Frontiers in endocrinology · 2023Review
- Extravillous trophoblast invasion and decidualization in cesarean scar pregnancies.Acta obstetricia et gynecologica Scandinavica · 2022Article
- Placenta Percreta Grade 3D - Lifeline to Morbid Catastrophe: An Invincible Challenge to Contemporary Obstetrics.International journal of applied & basic medical researchArticle
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe increasing cesarean section rate has led to an increase in the number of subsequent pregnancies resulting in a cesarean scar pregnancy. There appears to be preferential attachment of the blastocyst to the scar site, which may be associated with defective decidua in that region, resulting in abnormal implantation, which can in turn negatively affect the success of the pregnancy. The aim of the current study was to evaluate the extravillous trophoblast, decidua, and myometrium in scar and adjacent non-scar regions of the implantation site of a cesarean scar pregnancy. MATERIAL AND
methodsSamples containing a gestational mass were obtained by laparoscopic excision from patients with a cesarean scar pregnancy at 6-11 weeks of gestation as diagnosed by transvaginal or transabdominal ultrasound (n = 8 type II cesarean scar pregnancy). Cesarean scar pregnancy tissues were separated into scar and non-scar regions, and the scar regions were sub-separated into non-implantation and implantation sites. Serial sections were histologically examined after hematoxylin and eosin, Masson's trichrome and immunochemical staining, and changes in the myometrium, extravillous trophoblast, and decidua were evaluated.
resultsIn cesarean scar pregnancy, compared with scars not in the implantation site, scars in the implantation site displayed increased fibrosis, and had disrupted myometrium, which was related to varying patterns of E-cadherin expression as a response to extravillous trophoblast invasion. In addition, local decidua was found at the non-scar implantation sites, with multinucleated trophoblast giant cell accumulation and shallow invasion. These features were not evident in the scar implantation sites.
conclusionsThis study emphasizes that the decidua drives multinucleated trophoblast giant cell differentiation, limiting the degree of invasion. Better characterization of this differentiation process may be helpful for better management and avoidance of the consequences of cesarean scar pregnancy.
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