Matrix Metalloproteinase-9 in the Etiopathogenesis of Placenta Accreta Spectrum: A Literature Review

Putri Mirani1, Peby Maulina Lestari1, Krisna Murti2

  • 1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Dr. Mohammad Hoesin General Hospital/Faculty of Medicine Sriwijaya University, Palembang, South Sumatera, Indonesia.

The recent increase in placenta accreta spectrum has been correlated with a rise in the rate of cesarean sections. A recent study provides evidence that hampered wound healing results in cesarean scar defects that lead to a failure in the normal process of decidualization and deeper adherence of trophoblasts. Matrix metalloproteinase (MMP) is crucial in every step of wound healing as it alters the wound matrix, facilitating cell migration, as well as tissue remodeling. MMP-9 expression is higher in placental and decidual tissue in cases of placenta accreta. Based on these findings, assessment of MMP-9 expression can shed new light on the etiopathology of placenta accreta spectrum disorder and can be a potential diagnostic marker.