Placenta: Anatomopathological Examination, Biology, Immunological Features, Role in Guiding Fetal Development, Imaging and Placental Invasion Abnormalities

Dear Colleagues,

The placenta is a temporary organ that represents the interface between the maternal and fetal vascular beds. The placenta mediates nutrients and oxygen exchange, removes harmful waste, provides immune protection, and produces hormones to support fetal development. Placental cells (trophoblasts) accomplish this by invading and remodeling the uterine vasculature. Despite being of a fetal origin, trophoblasts do not trigger a significant maternal immune response. The placenta influences not just the health of a woman and her fetus during pregnancy, but it may also affect the lifelong health of both mother and child. In fact, the placenta has a pivotal role in guiding fetal development and metabolism. Despite this, the placenta is the least understood and least studied of all human organs.

Trophoblast invasion may sometimes be abnormal, infiltrating the myometrium of the uterine wall; this condition is named “invasive placenta” (accreta, increta, and percreta). Because of the abnormal attachment, invasive placenta is associated with an increased risk of massive bleeding and organ damage. The antenatal diagnosis of invasive placenta allows for referring patients to adequate centres for delivery. Ultrasonography and magnetic resonance imaging can be used for the diagnosis of placental invasion abnormalities. Unfortunately, placenta accrete cannot always be diagnosed before delivery. Maternal morbidity and mortality can occur because of severe and sometimes life-threatening haemorrhage, which often requires blood transfusions. Patients with placenta accreta spectrum are more likely to require a hysterectomy at the time of delivery or during the postpartum period and have longer hospital stays. The management of placenta accreta requires a multidisciplinary team accustomed to manage this condition.

The purpose of this Special Issue is to update the knowledge on the placenta. We encourage the submission of original manuscripts and reviews on this subject.

Prof. Dr. Simone Ferrero
Dr. Carolina Scala
Prof. Dr. Valerio Gaetano Vellone
Guest Editor

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