Obstetrics and GynecologyObstetrics and GynecologyАкушерство и гинекология0300-90922412-5679Bionika Media24786110.18565/aig.2017.2.5-10ArticlesСтатьиResearch ArticleThe modern concepts of etiology and pathogenesis placenta accreta and prospects of its prediction by molecular diagnosticsСовременные представления об этиопатогенезе врастания плаценты и перспективы его прогнозирования молекулярными методами диагностикиVinitskiyA. AВиницкийАлександр Анатольевич

Postgraduate student of maternity departments

аспирант родильного отделения

drvinitskiy@gmail.comShmakovR. GШмаковРоман Георгиевич

MD, PhD, the chief medical officer

д.м.н., главный врач

r_shmakov@oparina4.ruResearch Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of RussiaФГБУ НЦАГиП им. академика В.И. Кулакова Минздрава России150220172NO2 (2017)№2 (2017)51018022023Copyright ©; 2017, Bionika MediaCopyright ©; 2017, ООО «Бионика Медиа»2017Bionika MediaООО «Бионика Медиа»https://journals.eco-vector.com/0300-9092/article/view/247861

Objective. To conduct a systematic analysis of the data available in the current literature, risk factors, pathogenesis and markers, determined by laboratory diagnostic methods that indicate a placenta accreta. Subject and methods. The survey includes data of foreign and domestic items found in Pubmed on the subject, published in the last 5 years. Results. There are the basic molecular mechanisms that lead to placenta accreta. It is described risk factors and laboratory markers that allow to diagnose placenta accreta. Conclusion. There are many theories that consider the pathogenesis of placenta accrete by many sides. The most common one postulates about the important role of hypoxic factor with reduced vascular component of scar tissue on the uterus. It explains the high prevalence of this disease among women who have a caesarean section that was performed previously. A perspective direction is the prediction and diagnosis of placenta accreta by detecting of laboratory markers: some proteins, fetal DNA, mRNA, thereby complementing the instrumental imaging.

Цель исследования. Провести систематический анализ данных, имеющихся в современной литературе, факторах риска, патогенезе и маркерах, определяемых лабораторными методами диагностики, сигнализирующих о наличии врастании плаценты. Материалы и методы. В обзор включены данные зарубежных и отечественных статей, найденных в Pubmed по данной теме, опубликованных за последние 5лет. Результаты. Приведены основные молекулярные механизмы, приводящие к врастанию плаценты, описаны факторы риска и лабораторные маркеры, позволяющие с определенной степенью достоверности установить диагноз врастания плаценты. Заключение. Существует множество теорий, которые рассматривают патогенез врастания плаценты с разных позиций. Наиболее распространенная постулирует о значимости гипоксического фактора со сниженным сосудистым компонентом рубцовой ткани на матке, что в какой-то степени объясняет широкую распространенность данной патологии среди женщин, которым было ранее выполнено кесарево сечение. Перспективным является направление прогнозирования и диагностики врастания плаценты путем детекции лабораторных маркеров: ряда белков, фетальной ДНК, мРНК, тем самым дополняя методы инструментальной визуализации.

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