Immunological mechanisms of preterm abruption of the normally located placenta

Abstract

Data from the modern scientific literature concerning the etiology and pathogenesis of preterm abruption of normally located placenta were analyzed. Preterm placental abruption is a rare but very dangerous condition for the mother and fetus. This clinical situation occurs very quickly, and its consequences can be fatal. Because placental abruption can cause disability of the mother and fetus, it should be classified as a social problem.

This review included data from international and Russian articles published over the past decade. This literature review aimed to examine modern theories about molecular changes in the fetoplacental complex that occur during placental abruption. Available evidence suggests that disruption of immunological processes at the maternal–fetal interface is of key significance in the pathophysiology of placental abruption. The reviewed studies described signs of chronic noninfectious inflammation and an enhanced immunological cytotoxic response in placental abruption. Currently, obstetrics is a risk-based approach to medical care for pregnant women. Thus, understanding the predictors and mechanisms of the formation of this pregnancy complication is the key to predicting complications and providing highly competent medical care to patients.

Keywords

immunological reactions / preterm abruption of normally located placenta (PANLP) / inflammation

References

[1] Ailamazyan EK, Serov VN, Radzinskii VE, Savel’eva GM, editors. Obstetrics. National leadership. Short Edition. Moscow: GEOTAR-Media; 2021. 608 p. (In Russ).

[2] Акушерство. Национальное руководство. Краткое издание / под ред. Э.К. Айламазяна, В.Н. Серова, В.Е. Радзинского, Г.М. Савельевой. Москва : ГЭОТАР-Медиа, 2021. 608 с.

[3] Ananth CV, Lavery JA, Vintzileos AM, et al. Severe placental abruption: clinical definition and associations with maternal complications. Am J Obstet Gynecol. 2016;214(2):272.e1–e9. doi: 10.1016/j.ajog.2015.09.069

[4] Ananth C.V., Lavery J.A., Vintzileos A.M, et al. Severe placental abruption: clinical definition and associations with maternal complications // Am J Obstet Gynecol. 2016. Vol. 214, N. 2. P. 272.e1–e9. doi: 10.1016/j.ajog.2015.09.069

[5] Zharkin NA, Lavenyukova EM, Miroshnikov AE. Premature detachment of normally situated placenta. Epidemiology, risk factors, prognosis, outcomes. Russian Bulletin of Obstetrician-Gynecologist. 2018;18(3):2024. doi: 10.17116/rosakush201818320-24

[6] Жаркин Н.А., Лавенюкова Е.М., Мирошников А.Е. Преждевременная отслойка нормально расположенной плаценты. Эпидемиология, факторы риска, прогнозирование, исходы // Российский вестник акушера-гинеколога. 2018. Т. 18, № 3. С. 20–24. doi: 10.17116/rosakush201818320-24

[7] Tikkanen M, Gissler M, Metsaranta M, et al. Maternal deaths in Finland: focus on placental abruption. Acta Obstet Gynecol Scand. 2009;88(10):1124–1127. doi: 10.1080/00016340903214940

[8] Tikkanen M., Gissler M., Metsuranta M., et al. Maternal deaths in Finland: focus on placental abruption // Acta Obstet Gynecol Scand. 2009. Vol. 88, N. 10. P. 1124–1127. doi: 10.1080/00016340903214940

[9] Veerbeek JHW, Smit JG, Koster MP, et al. Maternal cardiovascular risk profile after placental abruption. Hypertension. 2013;61(6):1297–1301. doi: 10.1161/HYPERTENSIONAHA.111.00930

[10] Veerbeek J.H.W., Smit J.G., Koster M.P., et al. Maternal cardiovascular risk profile after placental abruption // Hypertension. 2013. Vol. 61, N. 6. P. 1297–1301. doi: 10.1161/HYPERTENSIONAHA.111.00930

[11] Geldenhuys J, Rossouw TM, Lombaard HA, Ehlers MM, Kock MM. Disruption in the Regulation of Immune Responses in the Placental Subtype of Preeclampsia. Front Immunol. 2018;9:1659. doi: 10.3389/fimmu.2018.01659

[12] Geldenhuys J., Rossouw T.M., Lombaard H.A., Ehlers M.M., Kock M.M. Disruption in the Regulation of Immune Responses in the Placental Subtype of Preeclampsia // Front Immunol. 2018. Vol. 9. P. 1659. doi: 10.3389/fimmu.2018.01659

[13] Goldstein JA, Gallagher K, Beck C, Kumar R, Gernand AD. Maternal-Fetal Inflammation in the Placenta and the Developmental Origins of Health and Disease. Front Immunol. 2020;11:531543. doi: 10.3389/fimmu.2020.531543

[14] Goldstein J.A., Gallagher K., Beck C., Kumar R., Gernand A.D. Maternal-Fetal Inflammation in the Placenta and the Developmental Origins of Health and Disease // Front Immunol. 2020. Vol. 11. P. 531543. doi: 10.3389/fimmu.2020.531543

[15] Yang F, Zheng Q, Jin L. Dynamic Function and Composition Changes of Immune Cells During Normal and Pathological Pregnancy at the Maternal-Fetal Interface. Front Immunol. 2019;10:2317. doi: 10.3389/fimmu.2019.02317

[16] Yang F., Zheng Q., Jin L. Dynamic Function and Composition Changes of Immune Cells During Normal and Pathological Pregnancy at the Maternal-Fetal Interface // Front Immunol. 2019. Vol. 10. P. 2317. doi: 10.3389/fimmu.2019.02317

[17] Mhatre MV, Potter JA, Lockwood CJ, Krikun G, Abrahams VM. Thrombin Augments LPS-Induced Human Endometrial Endothelial Cell Inflammation via PAR1 Activation. Am J Reprod Immunol. 2016;76(1):29–37. doi: 10.1111/aji.12517

[18] Mhatre M.V., Potter J.A., Lockwood C.J., Krikun G., Abrahams V.M. Thrombin Augments LPS-Induced Human Endometrial Endothelial Cell Inflammation via PAR1 Activation // Am J Reprod Immunol. 2016. Vol. 76, N. 1. P. 29–37. doi: 10.1111/aji.12517

[19] Nishimura F, Mogami H, Moriuchi K, et al. Mechanisms of thrombin-Induced myometrial contractions: Potential targets of progesterone. PLoS One. 2020;15(5):e0231944. doi: 10.1371/journal.pone.0231944

[20] Nishimura F., Mogami H., Moriuchi K., et al. Mechanisms of thrombin-Induced myometrial contractions: Potential targets of progesterone // PLoS One. 2020. Vol. 15, N. 5. P. e0231944. doi: 10.1371/journal.pone.0231944

[21] Baczkowska M, Zgliczynska M, Faryna J, et al. Molecular Changes on Maternal-Fetal Interface in Placental Abruption — A Systematic Review. Int J Mol Sci. 2021;22(12):6612. doi: 10.3390/ijms22126612

[22] Baczkowska M., Zgliczynska M., Faryna J., et al. Molecular Changes on Maternal-Fetal Interface in Placental Abruption — A Systematic Review // Int J Mol Sci. 2021. Vol. 22, N. 12. P. 6612. doi: 10.3390/ijms22126612

[23] Avagliano L, Falleni M, Marconi AM, et al. An imbalance of COX level is not related to placental abruption. J Clin Pathol. 2011;64(7):605–609. doi: 101136/jcp.2010.088765

[24] Avagliano L., Falleni M., Marconi A.M., et al. An imbalance of COX level is not related to placental abruption // J Clin Pathol. 2011. Vol. 64, N. 7. P. 605–609. doi: 10.1136/jcp.2010.088765

[25] Singh N, Herbert B, Sooranna G, et al. Distinct preterm labor phenotypes have unique inflammatory signatures and contraction associated protein profiles. Biol Reprod. 2019;101(5):1031–1045. doi: 10.1093/biolre/ioz144

[26] Singh N., Herbert B., Sooranna G., et al. Distinct preterm labor phenotypes have unique inflammatory signatures and contraction associated protein profiles // Biol Reprod. 2019. Vol. 101, N. 5. P. 1031–1045. doi: 10.1093/biolre/ioz144

[27] Schatz F, Guzeloglu-Kayisli O, Arlıer S, Kayisli UA, Lockwood CJ. The role of decidual cells in uterine hemostasis, menstruation, inflammation, adverse pregnancy outcomes and abnormal uterine bleeding. Hum Reprod Update. 2016;22(4):497–515. doi: 10.1093/humupd/dmw004

[28] Schatz F., Guzeloglu-Kayisli O., Arlıer S., Kayisli U.A., Lockwood C.J. The role of decidual cells in uterine hemostasis, menstruation, inflammation, adverse pregnancy outcomes and abnormal uterine bleeding // Hum Reprod Update. 2016. Vol. 22, N. 4. P. 497–515. doi: 10.1093/humupd/dmw004

[29] Downes KL, Grantz KL, Shenassa ED. Maternal, Labor, Delivery, and Perinatal Outcomes Associated with Placental Abruption: A Systematic Review. Am J Perinatol. 2017;34(10):935–957. doi: 10.1055/s-0037-1599149

[30] Downes K.L., Grantz K.L., Shenassa E.D. Maternal, Labor, Delivery, and Perinatal Outcomes Associated with Placental Abruption: A Systematic Review // Am J Perinatol. 2017. Vol. 34, N. 10. P. 935–957. doi: 10.1055/s-0037-1599149

RIGHTS & PERMISSIONS

Eco-Vector