title: Placenta accreta is associated with decreased decidual natural killer (dNK) cells population: a comparative pilot study.
abstract: OBJECTIVE
  Placenta accreta is a general term describes abnormal adherent placenta to the uterine wall. When the chorionic villi invade the myometrium, the term placenta increta is appropriate. Nowadays, it is one of the increasing causes of materno-fetal morbidities and mortality. The aim of this research was to evaluate density of decidual natural killer cells (dNK, CD56+(bright)) in decidua basalis in patients with placenta accreta.
  
  
  METHODS
  We recruited 76 patients from Ain Shams Maternity Hospital between June 2012 to August 2013, they were divided into study subgroup (A) which included 10 patients who underwent cesarean hysterectomy due to unseparated placenta accreta, study subgroup (B) included 16 patients with separated placenta accreta, a comparison group included 25 patients with placenta previa and a control group included 25 patients with normally situated placenta. All patients underwent elective cesarean delivery. Decidual biopsies were taken during the operation. An immunohistochemical staining for (dNK, CD56+(bright)) and a semi quantitative scoring were done. One-way ANOVA and Fisher Exact tests were used for statistical correlation.
  
  
  RESULTS
  The mean dNK cells scores were (0.4±0.5, 1.9±1, 3.3±0.5 and 3.5±0.5) for study subgroups (A), (B) comparison and control groups respectively) with a highly significant statistical difference (P<0.001). There was a significant statistical difference between study subgroups (A) and (B) P=0.002 .There was an insignificant statistical correlation between dNK scores and number of previous uterine scars (P=0.46).
  
  
  CONCLUSIONS
  These findings suggest that low dNK score was associated with cases of morbidly adherent placenta accreta.
authors.affiliation: Department of Obstetrics & Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. Electronic address: laban63@yahoo.com.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Laban
authors.affiliation: Department of Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: Eman Abdel-Salam
authors.initials: EA
authors.lastname: Ibrahim
authors.affiliation: Department of Obstetrics & Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: Mohammed Saeed Eldin
authors.initials: MS
authors.lastname: Elsafty
authors.affiliation: Department of Obstetrics & Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: Alaa Sayed
authors.initials: AS
authors.lastname: Hassanin
mesh_terms: D000328:Adult; D019002:CD56 Antigen / Q000032:analysis; D003430:Cross-Sectional Studies; D003656:Decidua / Q000473:pathology*; D005260:Female; D006801:Humans; D007694:Killer Cells, Natural / Q000737:chemistry; D010865:Pilot Projects; D010921:Placenta Accreta / Q000473:pathology*; D010923:Placenta Previa / Q000473:pathology; D011247:Pregnancy
chemical_list: D019002:CD56 Antigen
keywords: CD56+(bright); Cesarean section; Immunohistochemistry; Natural killer cells; Placenta accreta