The "Great Obstetrical Syndromes" are associated with disorders of deep placentation

Am J Obstet Gynecol. 2011 Mar;204(3):193-201. doi: 10.1016/j.ajog.2010.08.009. Epub 2010 Nov 20.


Defective deep placentation has been associated with a spectrum of complications of pregnancy including preeclampsia, intrauterine growth restriction, preterm labor, preterm premature rupture of membranes, late spontaneous abortion, and abruptio placentae. The disease of the placental vascular bed that underpins these complications is commonly investigated with targeted biopsies. In this review, we critically evaluate the biopsy technique to summarize the salient types of defective deep placentation, and propose criteria for the classification of defective deep placentation into 3 types based on the degree of restriction of remodeling and the presence of obstructive lesions in the myometrial segment of the spiral arteries.

Publication types

  • Research Support, N.I.H., Intramural
  • Review

MeSH terms

  • Biopsy
  • Female
  • Humans
  • Placenta / blood supply*
  • Placenta / pathology
  • Placenta Diseases / pathology
  • Placenta Diseases / physiopathology*
  • Pregnancy
  • Pregnancy Complications / pathology
  • Pregnancy Complications / physiopathology*
  • Syndrome