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Circulating trophoblast cell clusters for early detection of placenta accreta spectrum disorders.

ABSTRACT: Placenta accreta spectrum (PAS) is a high-risk obstetrical condition associated with significant morbidity and mortality. Current clinical screening modalities for PAS are not always conclusive. Here, we report a nanostructure-embedded microchip that efficiently enriches both single and clustered circulating trophoblasts (cTBs) from maternal blood for detecting PAS. We discover a uniquely high prevalence of cTB-clusters in PAS and subsequently optimize the device to preserve the intactness of these clusters. Our feasibility study on the enumeration of cTBs and cTB-clusters from 168 pregnant women demonstrates excellent diagnostic performance for distinguishing PAS from non-PAS. A logistic regression model is constructed using a training cohort and then cross-validated and tested using an independent cohort. The combined cTB assay achieves an Area Under ROC Curve of 0.942 (throughout gestation) and 0.924 (early gestation) for distinguishing PAS from non-PAS. Our assay holds the potential to improve current diagnostic modalities for the early detection of PAS.

SUBMITTER: Afshar Y

PROVIDER: S-EPMC8333096 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Dysregulated lncRNA and mRNA expression in placenta accreta spectrum disorders

Project description:To find potential biomarkers and molecular mechanism for placenta accreta spectrum disorders , we identified the differently expressed patterns of lncRNAs and mRNAs in invasive placneta and adherent normal placenta tissues. The results provided a novel insight into the pathogenesis of placenta accreta spectrum disorders .

2020-02-14 | GSE126552 | GEO

The importance of bladder volume in the ultrasound diagnosis of placenta accreta spectrum disorders.

Project description:ObjectiveTo assess how a quantifiable measure of vascularity-i.e. abnormal confluence (Acon ) in the subplacental myometrium observed by three-dimensional power-Doppler ultrasonography-changes with different bladder volumes.MethodsIn a prospective observational study, women referred to a tertiary UK center with suspected PAS disorders were recruited between August 2016 and May 2017. The largest area of confluent three-dimensional power-Doppler signal (Acon ) at the uteroplacental interface was estimated under two bladder volumes differing by at least 200 mL.ResultsAcon was calculated for 14 women, of whom seven were subsequently found to have PAS disorders. For these seven women, log(Acon ) was significantly greater when measured with a filled bladder than when measured with an unfilled bladder (P<0.001).ConclusionObjective evidence was found for a quantifiable difference in vascularity in the myometrium with bladder volume among women with PAS disorders. This difference has sufficient magnitude to influence the potential of Acon as a diagnostic marker.

| S-EPMC6449684 | biostudies-literature

The expression and biological function of chemokine CXCL12 and receptor CXCR4/CXCR7 in placenta accreta spectrum disorders.

Project description:ObjectivesInvestigation of mechanism related to excessive invasion of trophoblast cells in placenta accreta spectrum disorders (PAS) provides more strategies and ideas for clinical diagnosis and treatment.Materials and methodsBlood and placental samples were collected from included patients. The distribution and expression of CXCL12, CXCR4 and CXCR7 proteins in the paraffin of placental tissue in the included cases were analysed, and we analyse the downstream pathways or key proteins involved in cell invasion.ResultsFirstly, our results determined that CXCL12 and CXCR4/CXCR7 were increased in extravillous trophoblastic cell (CXCL12: P < .001; CXCR4: P < .001; CXCR7: P < .001), and the expression levels were closely related to the invasion depth of trophoblastic cells. Secondly, CXCL12 has the potential to become a biochemical indicator of PAS since the high expression of placental trophoblast CXCL12 may be an important source of blood CXCL12. Using lentivirus-mediated RNA interference and overexpression assay, it was found that both chemokine CXCL12 and receptor CXCR4/CXCR7 are associated with regulation of trophoblast cell proliferation, migration and invasion. Further results proved that through the activating the phosphorylation and increasing the expression of MLC and AKT proteins in the Rho/rock, PI3K/AKT signalling pathway, CXCL12, CXCR4 and CXCR7 could up-regulate the expression of RhoA, Rac1 and Cdc42 proteins to promote the migration and invasion of extravillous trophoblastic cell and ultimately formate the placenta accrete compare to the normal placenta.ConclusionsOur research proved that trophoblasts may contribute to a PAS-associated increase in CXCL12 levels in maternal blood. CXCL12 is not only associated with biological roles of PAS, but may also be potential for prediction of PAS.

| S-EPMC7077540 | biostudies-literature

Placenta Accreta Spectrum Outcomes Using Tourniquet and Forceps for Vascular Control.

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| S-EPMC8558214 | biostudies-literature

[Long non-coding RNAs show different expression profiles and display competing endogenous RNA potential in placenta accreta spectrum disorders].

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| S-EPMC6867958 | biostudies-literature

Up-regulated cytotrophoblast DOCK4 contributes to over-invasion in placenta accreta spectrum.

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Performance of antenatal imaging to predict placenta accreta spectrum degree of severity.

Project description:IntroductionIn cases of placenta accreta spectrum, a precise antenatal diagnosis of the suspected degree of invasion is essential for the planning of individual management strategies at delivery. The aim of this work was to evaluate the respective performances of ultrasonography and magnetic resonance imaging for the antenatal assessment of the severity of placenta accreta spectrum disorders included in the database. The secondary objective was to identify descriptors related to the severity of placenta accreta spectrum disorders.Material and methodsAll the cases included in the database for which antenatal imaging data were available were analyzed. The rates of occurrence of each ultrasound and magnetic resonance imaging descriptor were reported and compared between the Group "Accreta-Increta" (FIGO grades 1 & 2) and the Group "Percreta" (FIGO grade 3).ResultsAntenatal imaging data were available for 347 women (347/442, 78.5%), of which 105 were included in the Group "Accreta - Increta" (105/347, 30.2%) and 213 (213/347, 61.4%) in the Group "Percreta". Magnetic resonance imaging was performed in addition to ultrasound in 135 women (135/347, 38.9%). After adjustment for all ultrasound descriptors in multivariate analysis, only the presence of a bladder wall interruption was associated with a significant higher risk of percreta (Odds ratio 3.23, Confidence interval 1.33-7.79). No magnetic resonance imaging sign was significantly correlated with the degree of severity.ConclusionsThe performance of ultrasound and magnetic resonance imaging to discriminate mild from severe placenta accreta spectrum disorders is very poor. To date, the benefit of additional magnetic resonance imaging has not been demonstrated.

| S-EPMC8252006 | biostudies-literature

Dysregulated lncRNA and mRNA expression in placenta accreta spectrum disorders

Project description:Dysregulated lncRNA and mRNA expression in placenta accreta spectrum disorders

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Assessment of the massive hemorrhage in placenta accreta spectrum with magnetic resonance imaging.

Project description:The aim of the present study was to evaluate whether MRI features are able to predict massive hemorrhage of patients with placenta accreta spectrum (PAS). A total of 40 patients with suspected PAS after ultrasound examination were subjected to MRI. Of these, 29 patients were confirmed as having PAS. MRI data were analyzed independently by two radiologists in a blinded manner. Inter-observer agreement was determined. The 29 confirmed patients were divided into two groups (moderate and massive hemorrhage) according to the estimated blood loss (EBL) and blood transfusion, and the MRI features were compared between the two groups. The EBL, as well as blood transfusion, between the patients with and without each MRI feature were compared. The inter-observer agreement between the two radiologists for the 11 MRI features had statistical significance (P<0.05). Intra-placental thick dark bands and markedly heterogeneous placenta were the most important MRI features in predicting massive hemorrhage and blood transfusion (P<0.05). The difference in EBL between the patients with and without focal defect of the uteroplacental interface (UPI) was significant (P<0.05). The differences in blood transfusion between the patients with and without myometrial thinning, disruption of the inner layer of the UPI, increased placental vascularity and increased vascularity at the UPI were significant (P<0.05). These results indicate that MRI features may predict massive hemorrhage of patients with PAS, which may be helpful for pre-operative preparation of PAS patients.

| S-EPMC7027333 | biostudies-literature

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