Spiral artery remodeling and trophoblast invasion in preeclampsia and fetal growth restriction: relationship to clinical outcome.
TLDR
In this paper, the authors examined spiral artery remodeling and extravillous-cytotrophoblast in placental bed biopsies from normal pregnancy, preeclampsia, and severe FGR and compared with clinical parameters.Abstract:
Failure to transform uteroplacental spiral arteries is thought to underpin disorders of pregnancy, including preeclampsia and fetal growth restriction (FGR). In this study, spiral artery remodeling and extravillous-cytotrophoblast were examined in placental bed biopsies from normal pregnancy (n=25), preeclampsia (n=22), and severe FGR (n=10) and then compared with clinical parameters. Biopsies were immunostained to determine vessel wall integrity, extravillous-cytotrophoblast location/density, periarterial fibrinoid, and endothelium. Muscle disruption was reduced in myometrial spiral arteries in preeclampsia ( P =0.0001) and FGR ( P =0.0001) compared with controls. Myometrial vessels from cases with birth weight P P P P 5th percentile. Fewer extravillous-cytotrophoblast surrounded both decidual and myometrial vessels in the normal group and preeclampsia group compared with the FGR group ( P =0.001). For myometrial vessels, the normal group contained more intramural extravillous-cytotrophoblast than in preeclampsia ( P =0.015). Decidual vessels in the FGR group had less fibrinoid deposition compared with controls ( P =0.013). For myometrial vessels, less fibrinoid was deposited in both the preeclampsia group ( P =0.0001) and the FGR group ( P =0.01) when compared with controls, and less fibrinoid was deposited in the preeclampsia group when compared with FGR group ( P 5th percentile ( Pread more
Citations
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Journal ArticleDOI
Pre-eclampsia: pathophysiology and clinical implications
TL;DR: Recent research has focused on placental-uterine interactions in early pregnancy, and the aim now is to translate these findings into new ways to predict, prevent, and treat pre-eclampsia.
Journal ArticleDOI
Pre-eclampsia: pathogenesis, novel diagnostics and therapies.
Elizabeth A. Phipps,Elizabeth A. Phipps,Ravi Thadhani,Ravi Thadhani,Thomas Benzing,S. Ananth Karumanchi,S. Ananth Karumanchi +6 more
TL;DR: The pathogenic role of antiangiogenic proteins released by the placenta in the development of pre-eclampsia is discussed and novel therapeutic strategies directed at restoring the angiogenic imbalance observed during pre- eClampsia are reviewed.
Journal ArticleDOI
Pathophysiology of placental-derived fetal growth restriction.
Graham J. Burton,Eric Jauniaux +1 more
TL;DR: In this article, the authors found that placenta-related fetal growth restriction arises primarily due to deficient remodeling of the uterine spiral arteries supplying the placentas during early pregnancy, leading to selective suppression of protein synthesis and reduced cell proliferation.
Journal ArticleDOI
Why is placentation abnormal in preeclampsia
TL;DR: Work from this group showed that defects mirror deficits in the differentiation program that enables cytotrophoblast invasion of the uterine wall that hinders the cells interactions with spiral arterioles in preeclampsia.
Journal ArticleDOI
Endothelial dysfunction and preeclampsia: role of oxidative stress
TL;DR: Current literature from research showing the interplay between oxidative stress, ED and PE to the outcomes of current clinical trials aiming to prevent PE with antioxidant supplementation is reviewed.
References
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Journal ArticleDOI
Latest advances in understanding preeclampsia.
TL;DR: Recent work on the causes of preeclampsia is summarized, which reveals a new mode of maternal immune recognition of the fetus, relevant to the condition, and circulating factors derived from the placenta are now better understood.
Journal ArticleDOI
Inadequate maternal vascular response to placentation in pregnancies complicated by pre-eclampsia and by small-for-gestational age infants.
TL;DR: Findings point to a defect in the normal interaction between migratory trophoblast and maternal uterine tissues in pre‐eclampsia and in SGA, a feature not seen beyond the second trimester in normal pregnancy.
Journal ArticleDOI
The classification and diagnosis of the hypertensive disorders of pregnancy: statement from the International Society for the Study of Hypertension in Pregnancy (ISSHP)
TL;DR: The classification and diagnosis of the Hypertensive Disorders of Pregnancy: Statement from the International Society for the Study of Hypertension in Pregnancy (ISSHP), Vol. 20, No. 1, pp. ix-xiv as mentioned in this paper.
Journal ArticleDOI
The Uterine Spiral Arteries In Human Pregnancy: Facts and Controversies
TL;DR: Several features of the human placental bed are mirrored by processes in other species with haemochorial placentation, and studying such models may help to illuminate poorly understood aspects of human placenta and fetus.
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