Background: Abnormal PLACENTAl invasion has increased parallel with persistent rise in Caesarean delivery. Management relies on accurate diagnosis and delivery should be planned at an institution with appropriate expertise and resources for managing this condition.Case: We present a case of a PLACENTA invasion anomaly which is the major risk factors of peripartum deaths. In this case we try to explain our approach which reduces unnecessary hysterectomy rates.Conclusion: In order to avoid postpartum hemorrhage and hysterectomy protocols, our approach which consists bilateral hypogastric arterial ligation, Bakri balloon tamponade and If necessary methotrexate therapy can be applied succesfully.

IUGR is a major causes and silent illness and death in the embryonic and infants population, which in it infants growth potential is less than natural state. IUGR phrase and small for gestation age often used interchangeably. Although, there is small difference between these two.IUGR/SGA as a result different etiology including maternal factors, PLACENTA and fetus arise. That recently genetic factors added to it. IUGR may be caused by maternal smoking, infections agents and chromosomal or genetic abnormalities, maternal abnormalities, but in most cases secondary cause is PLACENTA insufficiency. IUGR often causes complications in the third trimester of pregnancy which is associated with symptoms of preeclampsia.The pathophysiology of IUGR is associated with PLACENTA insufficiency. It remains unclear, but the damage is usually caused due to failure of trophoblast invasion which causes intermittent blood flow the space between the intervillous that this also in turn causes local oxidative stress.

Objective: PLACENTA Accreta Spectrum (PAS) affects approximately one in a thousand deliveries. Very few studies evaluated PAS risk factors based on their location. In this study, we have investigated the effects of PLACENTA location on PLACENTAl adhesion-related complications, its risk factors, and outcomes. Materials and methods: We performed a retrospective cohort study of pathology-confirmed cases of PAS from patients with peripartum hysterectomy, at a large educational hospital in Qazvin, Iran, from 2009 to 2019. PLACENTA location was found by ultrasound reports and intraoperative evaluation. We measured demographic features, basic characteristics, maternal and neonatal outcomes based on PLACENTAl location including anterior, posterior, and lateral in PLACENTA Accreta Spectrum. Chi-square, t-test, and one-way ANOVA were used to examine the relation of complications, risk factors, and outcomes in PAS. Results: A review of 70 cases showed the distribution of PLACENTA location as follows: 57% anterior, 27% posterior, and 16% lateral. The mean gestational age at delivery was 35 (33-39) weeks. In 78. 6% (n=55) of the patients, an association with PLACENTA previa and in 94/2% (n=66) of cases a history of cesarean section was found, however, it was not significantly correlated with PLACENTA location (p=0. 082). We found that surgery duration was significantly longer in patients with lateral PAS (155±, 38, vs 129. 35±, 33. 8 and 133. 15±, 31. 5 for anterior and posterior PLACENTA respectively, p=0. 09). Patients with lateral PAS also bled more than the remaining two groups (2836 ml for lateral PAS vs 2002 and 1847 for anterior and posterior PLACENTA respectively, p=0. 022). Moreover, women with a history of uterine surgery were more likely to have posterior PAS compared to those with anterior and lateral PAS (p=0. 035). Conclusion: Differences in complications, risk factors, and outcomes of PAS based on PLACENTA location may lead to improved diagnosis and decreased morbidity in women.

Background: PLACENTA previa (PP) is an obstetric complication that can affect maternal and fetal morbidity and mortality. Its prevalence is rising due to cesarean sections. There is no quantitative data of PLACENTA in PP. In this study, quantitative parameters of PLACENTA in cases with PP in comparison with normally implanted controls were investigated.Methods: In this quasi experimental study, PLACENTAs from pregnancies with PP and normally implanted controls (n=10) were obtained from women who underwent cesarean section. Three full-thickness columns of each PLACENTA were sampled using systematic uniform random sampling (SURS). Columns were cut into slices and slices were sectioned with 4 mm thickness. SURS selected sections were stained by Masson’s trichrome. Stereological analysis was done on 8-10 SURS microscopic fields of each section. Absolute volume and volume density of chorionic villi, inter-villous space, syncytiotrophoblast, fibrin and blood vessels in chorionic villi were estimated in both groups. Statistical analysis was done using Mann Whitney-U test and significant level was set at p<0.05.Results: There was a significant reduction in total volume and volume density of fibrin deposits on the surface of chorionic villi (p<0.05), and a significant increment in total volume and volume density of chorionic villous blood vessels in PP group in comparison with C group (p<0.05).Conclusion: Results showed that impairment in situation of implantation in PP can cause significant changes in the structure of PLACENTA. These changes probably can be influential on the evolution and survival of fetus.