TROPHOBLAST ALTERATIONS IN THE PLACENTAL BED IN RELATION TO PHYSIOLOGICAL-CHANGES IN SPIRAL ARTERIES
TROPHOBLAST ALTERATIONS IN THE PLACENTAL BED IN RELATION TO PHYSIOLOGICAL-CHANGES IN SPIRAL ARTERIES
复制标题
DOI：
10.1111/j.1471-0528.1983.tb06743.x
复制
发表时间：
1983-01-01
期刊：
影响因子：
--
通讯作者：
ELEMA, JD
中科院分区：
文献类型：
--
作者：
GERRETSEN, G;HUISJES, HJ;ELEMA, JD
对93例胎盘床活检标本（其中53例有生理变化，40例无生理变化）进行组织学研究，包括滋养层穿透子宫壁的深度、滋养层多核巨细胞的形成以及间质（基质）和血管（壁内）滋养层的酶组织化学特征。滋养层渗透的深度与生理变化的存在或不存在无关。相反，在没有生理变化的情况下，在妊娠36周之前发现蜕膜-子宫肌层连接处的多核巨细胞显著积聚。胎盘床滋养细胞的酶组织化学特征表明滋养细胞向螺旋动脉的近端（蜕膜-子宫肌层）迁移，而远端可能被腔内（上游）侵入。提出的假设是，在没有生理变化的干扰间质迁移是由内在的（滋养层）或外在的（血管间质）的因素所表达的蜕膜-子宫肌层交界处的多核细胞的扩增。
Ninety‐three placental bed biopsies containing a segment of a spiral artery at the level of the decidual–myometrial junction (53 with and 40 without physiological changes) were histologically investigated for depth of trophoblastic penetration of the uterine wall, formation of trophoblastic multinucleated giant cells and the enzyme histochemical characteristics of the interstitial (stromal) and vascular (intramural) trophoblast. The depth of trophoblastic penetration was not related to the presence or absence of the physiological changes. Conversely, in the absence of physiological changes, a significant accumulation of multi‐nucleated giant cells at the decidual–myometrial junction was found before 36 weeks of gestation. The enzyme histochemical characteristics of the placental bed trophoblast suggest a stromal migration of trophoblast to the proximal (decidual–myometrial) part of the spiral artery whereas the distal part might be invaded by intraluminal (upstream) invasion. The hypothesis is put forward that in the absence of physiological changes a disturbed stromal migration is caused by intrinsic (trophoblastic) or extrinsic (interstitial of vascular) factors expressed by the augmentation of the multinucleated cells at the decidual–myometrial junction.