ABSTRACT
Objective Dangerous placenta previa(PPP) combined with placenta implantation seriously threatens maternal life safety. This paper aim to explore the changes of MnSOD and SIRT3,the expression of SIRT3 in maternal placenta PPP combined with placenta implantation, and the relationship between trophoblast invasion and placental implantation. Methods 90 cases with placenta implantation of pernicious placenta previa were collected from January 2014 to June 2018 in Anhui Maternal and Child Health Hospital. According to the depth of placental villus invading uterine myometrium, 30 cases of placenta adhesion, 30 cases of placental implantation, and 30 cases of placenta penetration, 30 cases of normal control group．Immunohistochemical SP and Western blot were used to detect the expression of MnSOD and SIRT3 in placental tissues of the study group and the control group, then compared and analyzed. Results Compared with the control group, the expression of MnSOD and SIRT3 in the placental implantation group were increased. With the increasing of placental implantation degree, the level of MnSOD and SIRT3 decreased significantly (P<0.05). Western blot showed that , the relative protein expressions of MnSOD/β-actin and SIRT3/β-actin in the control group were (0.39±0.05) and (0.41±0.08), which were higher than those in the adhesion group[(0.35±0.04), (0.32±0.02)], the implantion group[(0.28±0.02), (0.20±0.03)], and the penetration group[(0.23±0.01), (0.17±0.02)]. The difference was statistically significant(P<0.05). Conclusion The expressions of MnSOD and SIRT3 incytoplasm or nucleus of invasive trophoblasts and placental tissues of pregnant women with placental implantation is significantly decreased, both of which are involved in the occurrence and development of placental implantation, but the specific pathogenesis still needs to be further explored.
ABSTRACT
Objective To discuss the role of MRI in diagnosis and for the placenta previa and implantation presented negative in ultrasound.Methods Patients of placenta previa without placenta implantation confirmed by ultrasound were analyzed retrospectively.The patients were divided into A and B groups according to different treatment stages.A group underwent uterine segment cesarean section directly without MRI.B group underwent MRI scan first.And the MRI positive patients (B1 group) got abdominal aortic balloon temporarily block technique combined with the lower uterine segment cesarean section,if necessary,uterine artery embolization.The negative ones (B2 group) got uterine segment cesarean section directly.The placenta implantation was diagnosed by operation and (or) pathology.The maternal blood loss and hysterectomy rate between A and B group were compared.Results The sensitivity and specificity of MRI scan in placenta implantation was 0.75 and 0.916.The blood loss showed significant difference (P＜0.001).Hysterectomy rates presented no significant difference (P＞0.05).Conclusion When the ultrasound only showed placenta previa without implantation,the further test of MRI scan could detect the placenta implantation patients.After diagnosed by MRI,obstetrics and gynecology jointly intervene could effectively reduce the blood loss,or reduce the rate of hysterectomy.