Trophoblast plugs: impact on utero-placental haemodynamics and spiral artery remodelling

AbstractSTUDY QUESTIONHow does trophoblast plugging impact utero-placental haemodynamics?SUMMARY ANSWERPhysiological trophoblast plug structures are dense enough to restrict flow of oxygenated blood to the intervillous space (IVS) in the first trimester, and result in a shear stress environment upstream of the plugs that promotes spiral artery remodelling.WHAT IS KNOWN ALREADYTrophoblast plugging of the uterine spiral arteries is thought to be the dominant factor restricting the flow of oxygenated maternal blood to the placenta in the first trimester of pregnancy. However, the extent of plugging, the timing of plug break up, and the impact of plug structure on pregnancy outcomes is debated.STUDY DESIGN, SIZE, DURATIONA computational model of the uterine radial and spiral arteries, incorporating arteriovenous anastomoses was developed. The model was parameterized with our own histological data and previous literature descriptions of the dimensions of the spiral arteries, and the structural properties (porosity) of trophoblast plugs.PARTICIPANTS/MATERIALS, SETTING, METHODSStructural data were acquired from the literature, and supplemented by images of the spiral arteries acquired by standard thin-section 2D immunohistochemistry, and whole mount immunohistochemistry imaged in 3D by micro-CT. Computational models were solved using Matlab software, via custom written scripts.MAIN RESULTS AND THE ROLE OF CHANCEWe confirm that physiological lengths (>0.1 mm) and porosities (0.2 â...
Source: Human Reproduction - Category: Reproduction Medicine Source Type: research