Development of the Human Placenta and Fetal Heart: Synergic or Independent?
Development of the Human Placenta and Fetal Heart: Synergic or Independent?
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DOI：
10.3389/fphys.2018.00373
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发表时间：
2018
影响因子：
4
通讯作者：
Jauniaux E
中科院分区：
文献类型：
--
作者：
Burton GJ;Jauniaux E
胎盘是胎儿最大的器官，在妊娠末期，脐循环接收至少40%的双心室心输出量。因此，胎盘的发育与胎儿心脏的发育之间可能存在着密切的血液动力学联系，这并不奇怪。胎盘的发育是早熟的，而且比胎儿的发育要早。胎盘在妊娠的前三个月结束时经历相当大的重塑，并且其脉管系统能够适应环境条件和从母亲接收的血液供应的变化。胎盘膜有两个组成部分，次级卵黄囊和绒毛尿囊胎盘。卵黄囊是第一个血管化的胚外膜，在受孕后约17天（p.c.）产生内皮细胞和红细胞前体。在感染后约24天建立血管网络，卵黄静脉通过发育中的肝脏区域流入静脉窦。早期妊娠失败的卵黄囊通常显示卵黄囊的异常发育，这可能是继发于胎儿发育异常。绒毛尿囊胎盘的绒毛间充质中的血管发生也同样发生在早期。有核红细胞占据胎盘毛细血管的管腔，并且在前三个月的大部分时间内，脐动脉循环中不存在舒张末期血流，表明血流阻力高。在12-14周左右，脐-胎盘循环中的阻力开始下降。在正常的早期妊娠期间，胎盘毛细血管网络是可塑的，并且响应于局部氧浓度，特别是氧化应激，发生相当大的重构。在妊娠并发先兆子痫和/或胎儿生长受限的情况下，子宫胎盘灌注不良诱导胎盘动脉周围的平滑肌细胞去分化并采用增殖表型。这种变化与多普勒超声测量的脐阻力增加有关，并且可能通过后负荷对发育中的心脏产生重大影响。因此，脐带和母体胎盘循环都可能影响心脏的发育。
The placenta is the largest fetal organ, and toward the end of pregnancy the umbilical circulation receives at least 40% of the biventricular cardiac output. It is not surprising, therefore, that there are likely to be close haemodynamic links between the development of the placenta and the fetal heart. Development of the placenta is precocious, and in advance of that of the fetus. The placenta undergoes considerable remodeling at the end of the first trimester of pregnancy, and its vasculature is capable of adapting to environmental conditions and to variations in the blood supply received from the mother. There are two components to the placental membranes to consider, the secondary yolk sac and the chorioallantoic placenta. The yolk sac is the first of the extraembryonic membranes to be vascularized, and condensations in the mesenchyme at ~17 days post-conception (p.c.) give rise to endothelial and erythroid precursors. A network of blood vessels is established ~24 days p.c., with the vitelline vein draining through the region of the developing liver into the sinus venosus. Gestational sacs of early pregnancy failures often display aberrant development of the yolk sac, which is likely to be secondary to abnormal fetal development. Vasculogenesis occurs in the villous mesenchyme of the chorioallantoic placenta at a similarly early stage. Nucleated erythrocytes occupy the lumens of the placental capillaries and end-diastolic flow is absent in the umbilical arterial circulation throughout most of the first trimester, indicating a high resistance to blood flow. Resistance begins to fall in the umbilico-placental circulation around 12–14 weeks. During normal early pregnancy the placental capillary network is plastic, and considerable remodeling occurs in response to the local oxygen concentration, and in particular to oxidative stress. In pregnancies complicated by preeclampsia and/or fetal growth restriction, utero-placental malperfusion induces smooth muscle cells surrounding the placental arteries to dedifferentiate and adopt a proliferative phenotype. This change is associated with increased umbilical resistance measured by Doppler ultrasound, and is likely to exert a major effect on the developing heart through the afterload. Thus, both the umbilical and maternal placental circulations may impact on development of the heart.
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影响因子：
16
作者：
Barak, Y;Nelson, MC;Evans, RM
通讯作者：
Evans, RM
影响因子：
5
作者：
Doubilet, PM;Benson, CB;Chow, JS
通讯作者：
Chow, JS
DOI：
10.1073/pnas.1702560114
发表时间：
2017-06-13
影响因子：
11.1
作者：
Cindrova-Davies, Tereza;Jauniaux, Eric;Charnock-Jones, D. Stephen
通讯作者：
Charnock-Jones, D. Stephen
影响因子：
3.8
作者：
Burton, Graham J.;Jauniaux, Eric;Murray, Andrew J.
通讯作者：
Murray, Andrew J.
影响因子：
2.3
作者：
Baron, Margaret H.;Vacaru, Andrei;Nieves, Johnathan
通讯作者：
Nieves, Johnathan