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Objective: This study aimed to evaluate whether trophoblastic transforming growth factor beta (TGF-β) and E-cadherin expression levels have a role in placenta percreta (PP) aetiopathogenesis.Methods: This study was carried out in the Obstetrics & Gynecology and Pathology Departments of Harran University Medicine School. Forty-four women who underwent caesarean section for PP and other obstetric reasons were included in this study. PP was defined as the detection of placental invasion during the histopathological examination of the hysterectomy specimen, which passes the uterine wall as a whole layer and involves the uterine serosa. Placental tissue samples were collected from all pregnant patients to evaluate TGF-β and E-cadherin expression levels.Results: No significant difference was found in demographic features, including age, gestational week, number of pregnancies and body mass index, among the groups. Immunohistochemical staining against E-cadherin, a cell adhesion molecule, showed significantly reduced staining in PP patients (p = 0.048). TGF-β staining was also low in PP patients, but this difference was not significant (p = 0.107).Conclusions: The findings of this study suggest that a decrease in trophoblastic E-cadherin expression may have an important role in PP aetiopathogenesis. [ABSTRACT FROM AUTHOR]

Placenta accreta, which is a serious complication of pregnancy that can be treated with a spectrum of treatment methods ranging from medical treatment to hysterectomy, is characterized by the abnormal adherence of the placental tissue to the uterine wall. The presence of a simultaneous pulmonary embolus necessitates more conservative treatment approaches due to anticoagulant treatment and limited lung capacity of the patient. In this case report, a case with these risk factors that was treated with alternative treatment methods rather than surgery is presented and these treatment options are discussed. [ABSTRACT FROM AUTHOR]

The pathogenesis of placenta percreta (PP) is not very well known. This study was designed to analyse the oxidative stress (OS), the thiol/disulphide balance, and ischaemia-modified albumin (IMA) the women with PP. The study included 38 pregnant women with PP and 40 similarly aged healthy pregnant women in their third trimester of gestation. We measured the IMA, native and total thiols, and disulphide concentrations in the maternal sera of all of the participating women. The IMA levels were higher and the native and total thiols were lower in the PP group than in the control group. However, there was no statistical significance with respect to the thiol/disulphide balance between the two groups. The results of this study suggest that an increase in the ischaemia and OS and a decrease in the antioxidant status may contribute to the pathogenesis of PP. Impact statement What is already known on this subject? Placenta percreta (PP) is a serious complication of pregnancy. Although there are several studies investigating the pathophysiological mechanism of PP, whether the pathology results from a lack of decidua or from the over-invasiveness of trophoblasts remains controversial. The pathology of PP is poorly understood. What do the results of this study add? This prospective study has shown an increased ischaemia modified albumin (IMA) and a decreased antioxidant capacity in the patients with placenta percreta. The results from 38 women with PP suggest that the serum concentrations of IMA and the oxidative stress parameters may be able to predict PP in cases of uncertainty. What are the implications of these findings for clinical practice and/or further research? The implication of these findings shed light on understanding the pathogenesis of PP for further research. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the circulatory levels of endothelin 1 (ET-1) and the placental alkaline phosphatase (ALP) in pregnant women with placenta percreta (PP) and a control group.Methods: This study was carried out in the Obstetrics and Gynecology and in the Biochemistry Departments of Harran University Medical School. Forty-four women who underwent cesarean section (CS) due to PP and 44 women who underwent CS for other obstetric reasons were included in this study. The PP diagnosis was made by a pathologic examination that showed an extreme trophoblastic invasion involving the uterine serosa.The levels of circulating ET-1 and placental ALP were measured by an enzyme-linked immunosorbent assay (ELISA).Results: Women with PP more frequently received antenatal steroids and blood transfusions and they delivered at an earlier gestational age compared to controls. In women with PP, preoperative circulating ET-1 and placental ALP levels were lower than in the controls (p < .05 for both).Conclusions: The findings suggest that a decrease in ET-1 and placental ALP levels might play a role in the pathogenesis of PP. [ABSTRACT FROM AUTHOR]