Rôle de l’alpha-Foetoprotiene dans la physiopathologie du placenta accréta Etude biochimique et perspective diagnostique

Abstract

Placenta accreta is a severe obstetric pathology characterized by aberrant implantation of the placenta into the myometrium, frequently attributed to the absence of the basal decidual layer. This anomaly interferes with the normal process of post-partum placental detachment and leads to serious complications, including massive hemorrhage and emergency hysterectomies. Given the limitations of imaging techniques for early diagnosis, the identification of reliable serum biomarkers has become a research priority. Alpha-Fetoprotein (AFP), a fetal glycoprotein usually involved in the detection of neural tube defects, has recently attracted particular interest due to the elevation of its levels observed in some cases of placenta accreta. This work examines the potential role of AFP in the pathophysiology of placenta accreta, based on an extensive literature review and detailed biochemical analysis. The data collected indicate that increased serum AFP may reflect disruption of the uteroplacental barrier and excessive trophoblastic invasion. Furthermore, this glycoprotein appears to be involved in key processes such as the regulation of cell migration, angiogenesis and immune tolerance. While these observations are promising, the limitations associated with AFP's lack of specificity as a single biomarker make its combination with imaging techniques and other biomarkers essential to optimize the early diagnosis of placenta accrete.