The decidual suction method: a new way of collecting decidual tissue for functional and morphological studies

Abstract

Background. Studies of extravillous trophoblasts and placental bed spiral arteries are essential for a better understanding of pathological pregnancies such as preeclampsia, intrauterine growth restriction and diabetes mellitus. A major challenge is to obtain representative and sufficient tissue for morphological and functional investigations. Currently, tissue material is mostly harvested by placental bed biopsy (PBB). We describe a new suction method to obtain a larger volume of decidual tissue from the placental bed. Methods. Tissue was harvested in 51 cesarean sections by vacuum suction of the placental bed. Sections from formalin‐fixed, paraffin‐embedded tissue were routinely stained with hematoxylin and eosin (H&E), immunostained with a panel of antibodies and morphologically examined for the presence of trophoblasts and spiral arteries. The results were compared with those from archive material from PBBs and placental basal plate sections (BPSs). Short‐term adverse events were registered for the study patients. Long‐term complications were registered from medical charts of 151 women having undergone the decidual suction method (DSM), with a follow‐up of 38–60 months. Results. In 86% (n = 44), one random section from the decidual suction material demonstrated at least one spiral artery. In 37% (n = 19), six or more spiral arteries were present. All sections revealed extravillous trophoblasts. No short‐ or long‐term morbidity was recorded. Conclusions. The decidual suction method represents an important improvement in the work to obtain sufficient decidual tissue for morphological and functional studies of extravillous trophoblast function and spiral artery adaptation. The method is safe, as no short‐ or long‐term complications were registered.

Circulating and Placental Growth-Differentiation Factor 15 in Preeclampsia and in Pregnancy Complicated by Diabetes Mellitus

“…29 Decidual tissue from the placental bed was collected using a vacuum suction method developed and evaluated by our group. 30,31 Decidua represents the maternal-fetal interface and includes the maternal endometrium of pregnancy invaded by fetal extravillous trophoblasts. Placental biopsies were excised from a macroscopically normal looking, centrally located cotyledon, omitting the decidual layer.…”

Dysregulation of the Circulating and Tissue-Based Renin-Angiotensin System in Preeclampsia

“…Decidual tissue was collected through vacuum suctioning of the placental bed, as described previously. 8,9 Histopathologic confirmation of the decidual nature of the tissue was made on a random portion of each sample (by N.K.H.). All of the tissues were immediately frozen in liquid nitrogen and stored at Ϫ80°C.…”

“…We have established a safe decidual suction method yielding sufficient decidual tissue for morphological and functional studies of extravillous trophoblast function and spiral artery remodeling. 8,9 The renin-angiotensin system (RAS) participates in preeclampsia. We have described circulating agonistic autoantibodies directed at the angiotensin (Ang) II type 1 (AT 1 ) receptor in women with preeclampsia (AT1-AA).…”

STOX2 but not STOX1 is differentially expressed in decidua from pre-eclamptic women: data from the Second Nord-Trondelag Health Study

“…Decidua basalis tissue samples were collected by vacuum aspiration of the placental bed during Caesarean section as previously described (Staff et al ., 1999; Harsem et al ., 2004). Caesarean section in the control group was done for reasons considered irrelevant to the study hypotheses (breech presentation, cephalopelvic disproportion or maternal request).…”