Abstract
Placenta accreta spectrum (PAS) refers to the condition that placental trophoblast cells directly invade the myometrium, which is one of the most dangerous complications in obstetrics, but the pathogenesis has not been clarified. In recent years, the incidence of PAS was increasing, which has become the major reason leading to postpartum hemorrhage, perinatal emergency hysterectomy and maternal death. Available studies suggested that the occurrence of PAS was related to the following three interconnected factors: the loss of decidual membrane, enhanced trophoblast invasiveness and abnormal recasting of uterine spiral artery. This review focused on these three factors and tried to illustrate the pathophysiology of PAS. Key words: Placenta accreta; Decidua; Trophoblasts; Uterine artery
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