Spiral Artery Remodeling and Trophoblast Invasion in Preeclampsia and Fetal Growth Restriction: Relationship to Clinical Outcome

• Published in: Hypertension (Dallas, Tex. 1979) Tex. 1979), 2013-12, Vol.62 (6), p.1046-1054
• Main Authors: LYALL, Fiona, ROBSON, Stephen C, BULMER, Judith N
• Format: Article
• Language: English
• Subjects: Adult; Arterial hypertension. Arterial hypotension; Arteries - pathology; Biological and medical sciences; Birth Weight; Blood and lymphatic vessels; Cardiology. Vascular system; Cardiovascular system; Diseases of mother, fetus and pregnancy; Female; Fetal Development; Fetal Growth Retardation - pathology; Gynecology. Andrology. Obstetrics; Humans; Infant, Newborn; Investigative techniques, diagnostic techniques (general aspects); Medical sciences; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Myometrium - blood supply; Myometrium - pathology; Placenta - blood supply; Placenta - pathology; Pre-Eclampsia - pathology; Pregnancy; Pregnancy Outcome; Pregnancy. Fetus. Placenta; Trophoblasts - pathology; Tumors; Ultrasonic investigative techniques
• ISSN: 0194-911X; 1524-4563
• DOI: 10.1161/HYPERTENSIONAHA.113.01892

Failure to transform uteroplacental spiral arteries is thought to underpin disorders of pregnancy, including preeclampsia and fetal growth restriction (FGR). In this study, spiral artery remodeling and extravillous-cytotrophoblast were examined in placental bed biopsies from normal pregnancy (n = 25), preeclampsia (n = 22), and severe FGR (n = 10) and then compared with clinical parameters. Biopsies were immunostained to determine vessel wall integrity, extravillous-cytotrophoblast location/density, periarterial fibrinoid, and endothelium. Muscle disruption was reduced in myometrial spiral arteries in preeclampsia (P = 0.0001) and FGR (P = 0.0001) compared with controls. Myometrial vessels from cases with birth weight