Anatomical Studies of the Utero-Placental Vascularization in the First Trimester of Pregnancy

Hustin, J.; Schaaps, Jean-Pierre; Lambotte, R

doi:10.1007/978-1-4615-8109-3_4

Cited by 33 publications

(21 citation statements)

References 7 publications

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“…According to classical theories [24,25], true blood flow originating from spiral arteries is established in the intervillous space early in the first trimester. However, Hustin and co-workers [2,26], and Jauniaux et al [4,5] have challenged the classical theory and claimed that there is a trophoblastic shell, which separates the fetal circulation from the maternal circulation during the first trimester. According to the results of their Doppler ultrasonographic and hispathological studies, the tips of the spiral arteries are obstructed by intravascular trophoblastic plugs and the intervillous space is bathed by clear fluid, possibly made of filtered plasma and uterine gland secretions.…”

Section: Discussionmentioning

confidence: 99%

Uteroplacental Hemodynamics during Early Human Pregnancy: A Longitudinal Study

Mäkikallio

Tekay

Jouppila

2004

Gynecol Obstet Invest

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Background: To determine normal physiologic changes in the uteroplacental hemodynamics during early placental development in the first trimester of pregnancy. Methods: Sixteen normal singleton pregnancies were included in this longitudinal study. Transvaginal Doppler ultrasonographic examinations of uterine, arcuate, radial and spiral arteries were performed at the 5th, 7th, 8th and 10th completed gestational weeks. Peak systolic velocity (PSV), time-averaged maximum velocity (TAMXV) and the pulsatility index (PI) were measured. Results: Uterine artery PSV, TAMXV and PI remained unchanged from the 5th to the 8th week of gestation. From the 8th to the 10th week, PSV (p = 0.02) and TAMXV (p = 0.005) increased and PI decreased (p = 0.006). Changes in the arcuate arteries were similar to those in uterine arteries. No significant changes in PSV, TAMXV or PI of the radial artery were noticed. Spiral artery PSV (p = 0.02) and TAMXV (p = 0.02) increased from the 5th to the 7th week. Thereafter they remained unchanged. Spiral artery PI decreased from the 5th to the 10th week, (p = 0.004). Throughout the study period, the PSV, TAMXV and PI values were significantly higher in the uterine artery than in the arcuate artery, and in the arcuate artery compared with the radial artery. At the 5th gestational week, no differences in PSV and TAMXV were found between radial and spiral arteries. From the 7th gestational week onwards, PSV and TAMXV were significantly lower in the radial artery than in the spiral artery. However, the PI values in the radial artery were significantly higher compared with those in the spiral artery during the whole study period. Conclusions: Spiral artery impedance decreases and blood flow velocities increase as early as between the 5th and the 7th weeks of gestation. During that period, the uterine and arcuate artery hemodynamics remain unchanged. In the uterine and arcuate arteries, decreases in impedance and increases in absolute velocities are detected after the 8th week of gestation. This delay between the changes in the spiral and uterine arteries may represent the magnitude of the increase of placental volume and spiral arterial involvement which is needed to affect uterine hemodynamics.

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Section: Discussionmentioning

confidence: 99%

Uteroplacental Hemodynamics during Early Human Pregnancy: A Longitudinal Study

Mäkikallio

Tekay

Jouppila

2004

Gynecol Obstet Invest

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“…In addition, during this period in many species, the outermost embryonic layer formed by trophoblast giant cells (TGCs) invades the endometrium reaching and breaching the uterine vessels, maintains a close relationship with the maternal endothelium, and frequently lines the endometrial vessels [25][26][27][28][29][30]. This strategic position of the trophoblast interacting with vascular components and in direct contact with the maternal blood makes this cell population an attractive target for studies of the mechanisms that participate in the regulation of circulatory dynamics during the maternal-embryonic interrelationship.…”

Section: Introductionmentioning

confidence: 99%

Participation of the Mouse Implanting Trophoblast in Nitric Oxide Production During Pregnancy1

Gagioti

Scavone

Bevilacqua

2000

Biology of Reproduction

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While considerable progress has been made in elucidating nitric oxide (NO) regulatory mechanisms in the later stages of gestation, much less is known about its synthesis and role during embryo implantation. Thus, to evaluate the participation of the trophoblast in the production of NO during this phase, this study focused on NADPH-diaphorase activity and the distribution of NO synthase isoforms (NOS) using immunohistochemistry in pre- and postimplantation mouse embryos in situ and in vitro, as well as on NO production itself, measured as total nitrite, in trophoblast culture supernatants (Griess reaction). No NADPH-diaphorase activity was found in preimplanting embryos except after culturing for at least 48 h, when a few trophoblastic giant cells were positive. Conversely, postimplantation trophoblast cells either lodged into the implantation chamber (in situ) or after culturing (in vitro) showed intense NADPH-diaphorase activity. Also in the postimplantation trophoblast, the endothelial and inducible NOS (eNOS and iNOS) isoforms were immunodetected, under both in situ and in vitro conditions, although in different patterns. Extracts of ectoplacental cone also revealed bands of 135 and 130 kDa on SDS-PAGE that reacted with anti-eNOS and anti-iNOS, respectively, on Western blot. Analysis of the culture supernatant demonstrated that the nitrite concentration was 1) proportional to the number of cultured trophoblast cells, 2) almost completely abolished in the presence of N(omega)-nitro-L-arginine methyl ester, and 3) increased 2-fold in cultures stimulated with gamma-interferon. These results strongly suggest the production of NO from constitutive and inducible isoforms of NOS by the implanting mouse trophoblast. They also emphasize the possibility of the participation of these cells in vasodilatation and angiogenesis, and in cytotoxic mechanisms involved in the intense phagocytosis of injured maternal cells, which occur during the implantation process.

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“…Jaffe et al [25] showed that the intervillous circulation is not fully established until the end of the 1st trimester. Ex vivo studies of hysterectomy specimens of pregnant uteri have demonstrated that trophoblastic plugs obstruct blood flow into the intervillous space during early pregnancy, and only at 12-13 weeks do these plugs become loose and allow for continuous maternal blood flow into the intervillous space [26,27]. These findings imply that a very limited amount of maternal blood reaches the intervillous space during the first 12 weeks of gestation.…”

Section: Discussionmentioning

confidence: 84%

Serum Angiogenin Levels during Menstrual Cycle and Pregnancy

Hayashi

Yanagihara

Hata

2000

Gynecol Obstet Invest

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Objective: To evaluate alterations in maternal circulating angiogenin levels with advancing gestation and to assess the effect of labor stress on serum angiogenin levels in neonates delivered vaginally and by cesarean section. Methods: The maternal circulating angiogenin concentrations were compared in 37 normotensive nonpregnant women, in 60 normotensive pregnant women from 7 to 41 weeks of gestation, and in 12 normotensive postpartum women on the 3rd puerperal day. The serum angiogenin concentrations were also measured in 12 patients with threatened premature labor. Moreover, maternal and fetal serum angiogenin samples before and after delivery were used to determine differences in 12 neonates delivered vaginally and in 11 neonates delivered by elective cesarean section. The serum angiogenin level was measured using an enzyme-linked immunosorbent assay. Results: There was no significant difference in serum angiogenin levels during each phase of the menstrual cycle. The serum angiogenin levels were decreaseing until 15 weeks of gestation and increasing thereafter. There was no significant difference in serum angiogenin levels between normal pregnant women and in patients with threatened premature labor. Labor stress did not affect either maternal or fetal serum angiogenin concentrations. The serum angiogenin levels of the neonates were significantly lower than those in maternal serum after both vaginal delivery and delivery by cesarean section. Conclusion: These results suggest that regulatory mechanisms of angiogenin may exist during pregnancy.

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Anatomical Studies of the Utero-Placental Vascularization in the First Trimester of Pregnancy

Cited by 33 publications

References 7 publications

Uteroplacental Hemodynamics during Early Human Pregnancy: A Longitudinal Study

Uteroplacental Hemodynamics during Early Human Pregnancy: A Longitudinal Study

Participation of the Mouse Implanting Trophoblast in Nitric Oxide Production During Pregnancy1

Serum Angiogenin Levels during Menstrual Cycle and Pregnancy

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