The main goal of this study is to assess the role of Netrin 1, neogenin and ZEB1 in PAS-associated invasion

• To evaluate the immunohistochemical expression of these proteins in PAS specimens in comparison with the control placental tissues.
• To correlate their expression with the demographic parameters.
• To assess the correlation between their expression in PAS specimens.

inclusion criteria

• PAS patients who underwent hysterectomy to allow proper pathologic grading of PAS

exclusion criteria

• patients with fundal and middle anterior or posterior placenta,
• pregnancy associated with morbid conditions such as hypertension, diabetes mellitus, autoimmune disease, cardiac disease, renal disease, history of anemia, blood transfusion, other blood diseases and endocrinal disease; fetal distress or intrauterine growth retardation.
• uterine scar pregnancies were excluded

30 PAS specimens and 30 placental specimens from matched control.