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Related Experiment Video

Updated: Jan 7, 2026

Mouse Model of Surgical Uterine Injury and Subsequent Pregnancy Outcomes
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Pathophysiology and Management of Placenta Accreta Spectrum.

Lana Shteynman1, Genevieve Monanian2, Gilberto Torres1

  • 1Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, USA.

Journal of Developmental Biology
|December 24, 2025
PubMed
Summary

Placenta Accreta Spectrum (PAS) disorders involve abnormal placental adherence, risking severe hemorrhage and hysterectomy. Understanding PAS pathophysiology and optimizing management are crucial for reducing maternal complications.

Keywords:
decidualizationepithelial-to-mesenchymal transition (EMT)extracellular matrix remodelingextravillous trophoblastsmaternal morbidityplacenta accreta spectrumpostpartum hemorrhagepreoperative planning

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Reproductive Biology

Background:

  • Placenta Accreta Spectrum (PAS) disorders are increasingly prevalent obstetric conditions.
  • PAS involves abnormal placental adherence to the uterine wall, leading to significant maternal risks.
  • Key risk factors include prior cesarean sections, uterine surgery, and placenta previa.

Purpose of the Study:

  • To review the pathophysiology of PAS, focusing on abnormal trophoblast invasion and decidualization.
  • To highlight factors contributing to abnormal placentation and delivery complications.
  • To discuss life-threatening complications and management optimization strategies.

Main Methods:

  • Review of existing literature on Placenta Accreta Spectrum disorders.
  • Examination of the mechanisms underlying abnormal trophoblast invasion and decidualization.
  • Analysis of the role of uterine scarring, ECM remodeling, signaling pathways, and vascular alterations.

Main Results:

  • PAS pathophysiology involves defective decidualization and abnormal trophoblast invasion.
  • Uterine scarring, ECM remodeling, and altered maternal-fetal interface contribute to PAS.
  • PAS can lead to massive hemorrhage, shock, multi-organ failure, and often requires hysterectomy.

Conclusions:

  • PAS is a serious obstetric condition with increasing incidence and severe potential complications.
  • Multidisciplinary intensive care and optimized management are essential for reducing maternal morbidity and mortality.
  • Preoperative planning and intraoperative blood loss control are critical for managing PAS effectively.