Human placental oxygenation in late gestation: experimental and theoretical approaches.
Human placental oxygenation in late gestation: experimental and theoretical approaches.
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DOI：
10.1113/jp275633
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发表时间：
2018-12
期刊：
影响因子：
--
通讯作者：
Brownbill P
中科院分区：
文献类型：
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作者：
Nye GA;Ingram E;Johnstone ED;Jensen OE;Schneider H;Lewis RM;Chernyavsky IL;Brownbill P
胎盘对生命至关重要。它是一个短暂但复杂的器官，作为母体和胎儿循环之间的屏障界面，提供气体，营养物质，激素，废物和免疫球蛋白的交换。在我们对胎盘结构和功能的详细理解中存在许多差距，特别是在子宫内健康和病理状态下的氧气处理和转移方面。了解人体体内氧转移的测量是有限的，对最合适的方法没有普遍的一致意见。本文报道了一种在剖腹产时通过针电极插入测量绒毛间隙氧分压的有创方法。这允许在体内直接测量，同时保持接近正常的胎盘条件;然而，使用这种方法测定胎盘氧合存在实际和伦理方面的影响。此外，胎盘内的氧水平可能是高度异质的。新兴的非侵入性技术（如MRI）和离体研究能够增强和改善目前胎盘绒毛结构的成像方法，并提高胎盘隔室内氧气测量的精度。这些技术与数学建模相结合，激发了新的跨学科方法，可以促进我们对正常和病理妊娠中胎盘氧合及其代谢的理解，改善临床治疗选择并最终改善患者的结局。
The placenta is crucial for life. It is an ephemeral but complex organ acting as the barrier interface between maternal and fetal circulations, providing exchange of gases, nutrients, hormones, waste products and immunoglobulins. Many gaps exist in our understanding of the detailed placental structure and function, particularly in relation to oxygen handling and transfer in healthy and pathological states in utero. Measurements to understand oxygen transfer in vivo in the human are limited, with no general agreement on the most appropriate methods. An invasive method for measuring partial pressure of oxygen in the intervillous space through needle electrode insertion at the time of Caesarean sections has been reported. This allows for direct measurements in vivo whilst maintaining near normal placental conditions; however, there are practical and ethical implications in using this method for determination of placental oxygenation. Furthermore, oxygen levels are likely to be highly heterogeneous within the placenta. Emerging non‐invasive techniques, such as MRI, and ex vivo research are capable of enhancing and improving current imaging methodology for placental villous structure and increase the precision of oxygen measurement within placental compartments. These techniques, in combination with mathematical modelling, have stimulated novel cross‐disciplinary approaches that could advance our understanding of placental oxygenation and its metabolism in normal and pathological pregnancies, improving clinical treatment options and ultimately outcomes for the patient.