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CME Credit Offered
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Abstract Award
Recording available 2/16-5/2
Recording available 2/16-5/2
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AIUM Credit
Foundation Awardee
Foundation Awardee
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Abstract Award
Abstract Award
Foundation Awardee
Foundation Awardee

Poster Session 4

Category: Clinical Obstetrics

Poster Session 4

(1262) Decidual Transcriptome Profiling Unravels Key Dysregulated Genes in Cesarean Scar Ectopic Pregnancy

Thursday, February 12, 2026
3:30 PM - 5:00 PM  
Foundation Awardee

    Submitting Author and Presenting Author(s)

  • Shuai Zeng, Medicial Master (he/him/his)

    Peking University Third Hospital
    Beijing, Beijing, China (People's Republic)

    • Coauthor(s)

  • LC

    Lian Chen, MD

    Peking University Third Hospital
    Beijing, Beijing, China (People's Republic)

  • JQ

    Jiangxue Qu, PhD

    Peking University Third Hospital
    Beijing, Beijing, China (People's Republic)

  • HJ

    Hai Jiang, PhD

    Peking University Third Hospital
    Beijing, Beijing, China (People's Republic)

  • YZ

    Yangyu Zhao, MD

    Peking University Third Hospital
    Beijing, Beijing, China (People's Republic)

Objective:
Cesarean scar ectopic pregnancy (CSEP), characterized by embryo implantation within a previous caesarean section (CS) scar, represent a rare yet increasingly prevalent condition. A critical concern is its frequent progression to placenta accreta spectrum (PAS) disorders, though the underlying mechanisms remain poorly understood. Emerging evidence suggests that aberrant decidualization in CSEP may create a permissive microenvironment for excessive extravillous trophoblast (EVT) invasion, thereby bridging CSEP to PAS pathogenesis. The precise molecular signatures in CSEP-derived decidua tissues remain uncharacterized. Elucidating the decidual-pathology-driven mechanisms in CSEP could not only reveal early molecular triggers of PAS but also provide critical insights for risk stratification: identifying CSEP cases with potential for continued pregnancy versus those requiring intervention, and paving the way for targeted therapies to mitigate PAS progression.

Study Design:
We performed total RNA sequencing on decidual tissues obtained from 6 CSEP and 12 normal pregnancy cases at 6-9 weeks of gestation. Differential expressed genes (DEGs) were identified, followed by qRT-PCR validation.Functional enrichment analysis (GO, KEGG) and immune infiltration analysis were conducted.

Results:

Comparative transcriptomics identified 117 upregulated and 662 downregulated DEGs in decidua. Upregulated transcripts were prioritized for pathway analysis, revealing significant enrichment in TNF and chemokine signaling pathways (Figure 1). Immune infiltration analysis implicated macrophages, neutrophils and dendric cells as key players, with hub genes (CCL2, CCL3, EGR1, CYR61, JUNB, FOS, JUN) exhibiting pronounced upregulation in CSEP, as confirmed by qRT-PCR (Figure 2).


Conclusion:

Our study delineates the unique transcriptional landscape of CSEP decidua, uncovering dysregulated inflammatory and immune-reflect pathways that may drive CSEP pathogenesis and its progression to PAS. These findings provide novel molecular insights and potential therapeutic targets for mitigating adverse outcomes in high-risk pregnancies.