The Study Of Pigment Epithelium-derived Factor(PEDF) On Abnormal Placental Location And The Formation Of Abnormal Placental Microvascular Bed

Objective Objective to investigate the effect of PEDF on abnormal placental location and the formation of abnormal placental microvascular bed,to elucidate of PEDF on abnormal placental microvascular bed and microvessel density by affecting VEGF,the possibility and related mecchanism of abnormal placenta ormation in the abnormal position of placenta.As well as to investigate whether PEDF can be use as an effective marker for the diagnosis of abnormal peripheral blood markers of placental site attachment.Methods From July 2014 to July 2015 in maternity cesarean delivery and obstetrics of Fujian Provincial-owned Hospitai of Fujian provincial Jinshan Hospital a total of48 cases,.32 cases of abnormal placental location,among them,16 cases were placenta accreta,16 cases were placenta praevia,;because of abnormal fetal position,social factors of cesarean section in 16 cases in the control group.Immunohistochemical technique was used to detect the expression of PEDF and VEGF in placenta of three groups,vascular endothelial cells were labeled with CD34 monoclonal antibody and microvessel density was calculated,and all the placentas were examined pathologically,Western Blot was used to detect the expression of PEDF and VEGF protein in three groups,the expression of PEDF and VEGF in placenta of three groups was detected by RT-PCR,detection of PEDF and VEGF levels in peripheral serum of pregnant women with cesarean section by ELISA.The differences of PEDF,VEGF,MVD and the correlation between three groups of placenta accreta group,placenta praevia group and control group were analyzed.Correlation analysis of PEDF and VEGF expression in peripheral blood.Results(1)PA group,PP group and the control group,the expression of PEDF and VEGF in placental tissuethree of the three groups was expressed on vascular endothelial cells,and PEDF,VEGF protein content,PEDFm RNA,VEGFm RNA content were statistically singnificant differences(P<0.05),(2)PA group,PP group,and the control group,the three groups of placental MVD differences were statistically singnificant(P<0.05),(3)There was no statistically singnificant in PEDF and VEGFlevels in perpheral blood of PA group,PP group and the control group(P>0.05),(4)There was a negative correlation between the expression of PEDF in placenta and the expression of VEGF in placenta(r=-0.778,P=0.000),and was negative correlation with the microvessel density(r=-0.827,P=0.000),and was no correlation with PEDF in peripheral blood(r=0.152,P=0.302),the expression of VEGF in placenta was positively correlated with MVD(r=-0.898,P=0.000).(5)Pathological results of three groups of placenta,in the group PA,the area of placenta tissue was increased,the texture was fragile,and the number of villi increased significantly,some villi invade the vascular wall of the myometrium and the muscularis,trophoblastic fibrous necrosis,hyaline degeneration of blood vessel,focal infarction and necrosis;in the group PP,the area of placenta tissue was increased,the number of villi increased,but the degree of reduction,gestational trophoblastic necrosis and hyaline degeneration of blood vessel,with or without infiltration of inflammatory cells.There was no change in the control group.Conclusions(1)The expression of PEDF was significantly lower in the placenta of abnormal placental position group(PA group,PP group),and PEDF was negatively correlated with VEGF and MVD,it is suggested that the low expression of PEDF in placental tissues of the placental site attachment abnormal group is the reason of the inhibition of VEGF and the formation of placental pathological vascular,and PEDF is involved in the occurrence of abnormal placental location.(2)The content of PEDF and the content of VEGF in the PA group,PP group and the control group three groups were significantly different,PEDF with the degree of placental invasion of the uterus,the deeper the invasion,the lower the content of PEDF,but VEGF increased with the degree of placental invasion of the uterus,and the deeper the invasion,the higher the content of VEGF,there results suggest that PEDF and VEGF can reflect the degree of placental vascular invasion.(3)There was no difference in the expression level of PEDF and VEGF in peripheral blood,which was not excluded from the sample size,the future will increase the sample size for further study.