{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T14:24:08Z","timestamp":1791901448511,"version":"4.3.4"},"reference-count":80,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2024,9,8]],"date-time":"2024-09-08T00:00:00Z","timestamp":1725753600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Placenta accreta spectrum (PAS) disorders are characterized by abnormal trophoblastic invasion into the myometrium, leading to significant maternal health risks. PAS includes placenta accreta (invasion &lt; 50% of the myometrium), increta (invasion &gt; 50%), and percreta (invasion through the entire myometrium). The condition is most associated with previous cesarean deliveries and increases in chance with the number of prior cesarians. The increasing global cesarean rates heighten the importance of early PAS diagnosis and management. This review explores genetic expression and key regulatory processes, such as apoptosis, cell proliferation, invasion, and inflammation, focusing on signaling pathways, genetic expression, biomarkers, and non-coding RNAs involved in trophoblastic invasion. It compiles the recent scientific literature (2014\u20132024) from the Scopus, PubMed, Google Scholar, and Web of Science databases. Identifying new biomarkers like AFP, sFlt-1, \u03b2-hCG, PlGF, and PAPP-A aids in early detection and management. Understanding genetic expression and non-coding RNAs is crucial for unraveling PAS complexities. In addition, aberrant signaling pathways like Notch, PI3K\/Akt, STAT3, and TGF-\u03b2 offer potential therapeutic targets to modulate trophoblastic invasion. This review underscores the need for interdisciplinary care, early diagnosis, and ongoing research into PAS biomarkers and molecular mechanisms to improve prognosis and quality of life for affected women.<\/jats:p>","DOI":"10.3390\/ijms25179722","type":"journal-article","created":{"date-parts":[[2024,9,9]],"date-time":"2024-09-09T05:59:08Z","timestamp":1725861548000},"page":"9722","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["The Underlying Molecular Mechanisms of the Placenta Accreta Spectrum: A Narrative Review"],"prefix":"10.3390","volume":"25","author":[{"given":"Erik","family":"Liz\u00e1rraga-Verdugo","sequence":"first","affiliation":[{"name":"Research Unit, Center for Research and Teaching in Health Sciences, Autonomous University of Sinaloa, Culiacan 80030, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8411-0957","authenticated-orcid":false,"given":"Sa\u00fal Armando","family":"Beltr\u00e1n-Ontiveros","sequence":"additional","affiliation":[{"name":"Research Unit, Center for Research and Teaching in Health Sciences, Autonomous University of Sinaloa, Culiacan 80030, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erick Paul","family":"Guti\u00e9rrez-Grijalva","sequence":"additional","affiliation":[{"name":"C\u00e1tedras CONAHCYT-Food and Development Research Center (CIAD) A.C., Culiacan 80110, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marisol","family":"Montoya-Moreno","sequence":"additional","affiliation":[{"name":"Research Unit, Center for Research and Teaching in Health Sciences, Autonomous University of Sinaloa, Culiacan 80030, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3713-3056","authenticated-orcid":false,"given":"Perla Y.","family":"Guti\u00e9rrez-Arzapalo","sequence":"additional","affiliation":[{"name":"Research Unit, Center for Research and Teaching in Health Sciences, Autonomous University of Sinaloa, Culiacan 80030, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana","family":"Avenda\u00f1o-F\u00e9lix","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry, Autonomous University of Sinaloa, Culiacan 80010, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karla Paola","family":"Guti\u00e9rrez-Castro","sequence":"additional","affiliation":[{"name":"Research Unit, Center for Research and Teaching in Health Sciences, Autonomous University of Sinaloa, Culiacan 80030, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel E.","family":"Cu\u00e9n-Lazcano","sequence":"additional","affiliation":[{"name":"Research Unit, Center for Research and Teaching in Health Sciences, Autonomous University of Sinaloa, Culiacan 80030, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6405-5097","authenticated-orcid":false,"given":"Paul","family":"Gonz\u00e1lez-Quintero","sequence":"additional","affiliation":[{"name":"Gynecology and Obstetrics Service, Women\u2019s Hospital of Culiacan, Health Secretary, Culiacan 80020, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1748-0760","authenticated-orcid":false,"given":"Carlos Ernesto","family":"Mora-Palazuelos","sequence":"additional","affiliation":[{"name":"Research Unit, Center for Research and Teaching in Health Sciences, Autonomous University of Sinaloa, Culiacan 80030, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Markfeld Erol, F., H\u00e4u\u00dfler, J.A., Medl, M., Juhasz-Boess, I., and Kunze, M. 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