Deep placentation
Deep placentation
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DOI：
10.1016/j.bpobgyn.2010.10.009
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发表时间：
2011-06-01
影响因子：
5.5
通讯作者：
Brosens, I.
中科院分区：
文献类型：
--
作者：
Pijnenborg, R.;Vercruysse, L.;Brosens, I.
人类妊娠中的深层胎盘形成是通过绒毛外滋养层细胞对胎盘床的深层侵袭实现的，涉及蜕膜和子宫内(交界区)肌层。间质侵袭和血管内滋养细胞侵袭螺旋动脉均可发生。深血管内滋养细胞侵袭螺旋动脉的肌层对于胎盘的正常功能非常重要。在这种广泛的血管侵入开始之前，蜕膜相关的血管重塑，包括血管平滑肌的肿胀和组织紊乱，发生在胎盘含氧量上升的时期。这一早期的重建步骤可能会适应逐渐增加的流向发育中胎盘的母体血流量。随后与滋养层相关的重塑步骤增强和稳定了血管的增宽，而血管平滑肌和弹力板被嵌入滋养层的纤维蛋白基质所取代。在妊娠并发症中，深度重塑缺陷会导致胎盘功能障碍。(C)2010爱思唯尔有限公司。保留所有权利。
Deep placentation in human pregnancy is realised by deep invasion of the placental bed by the extravillous trophoblast, involving the decidua and the inner (junctional zone) myometrium. Interstitial invasion of the stroma and endovascular trophoblast invasion of the spiral arteries both occur. Deep endovascular trophoblast invasion into the myometrial segments of spiral arteries is important for proper placental functioning. Before this extended vascular invasion begins, decidua-associated vascular remodelling, which includes swelling and disorganisation of the vascular smooth muscle, occurs during a period of rising placental oxygen. This early remodelling step may accommodate the progressively increasing maternal blood flow to the developing placenta. The subsequent trophoblast-associated remodelling step enhances and stabilises the widening of the vessels, whereas the vascular smooth muscle and elastic lamina are replaced by a fibrinoid matrix with embedded trophoblast. Defective deep remodelling contributes to placental malfunctioning in complications of pregnancy. (C) 2010 Elsevier Ltd. All rights reserved.