Document Detail


Developmental biology of the placenta and the origins of placental insufficiency.
MedLine Citation:
PMID:  15691771     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Defects in all the trophoblast-differentiating pathways--endovascular, interstitial and chorionic villous--play a role in the pathogenesis of early-onset intra-uterine growth restriction (IUGR). There are two types of extravillous trophoblast: endovascular trophoblast, that forms the definitive placenta by occlusion of the spiral arteriole at the implantation site, and interstitial extravillous trophoblast, responsible for the anatomical erosion of the distal spiral arteriole and the secretion of angiogenic and vasodilator signals to improve uterine blood flow. Defective endovascular erosion may render the basal plate inadequate to meet the demands of the fetus. Failed interstitial invasion of spiral arterioles could lead to failure of local angiogenic and systemic cardiovascular adaptation signals that could be the underlying basis for early-onset IUGR and pre-eclampsia. As debate persists regarding the relative importance of cord, stem and terminal villous pathology, the study of factors controlling trophoblast turnover from immature intermediate villi to conductance stem villi and gas-exchanging terminal villi, translation of our knowledge from mouse placental genetics into human placental development, and defining causes of thrombo-occlusive damage to the placenta would help our understanding of the pathophysiology of early-onset IUGR.
Authors:
Vandana Chaddha; Sandra Viero; Berthold Huppertz; John Kingdom
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Seminars in fetal & neonatal medicine     Volume:  9     ISSN:  1744-165X     ISO Abbreviation:  -     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2005-02-04     Completed Date:  2005-06-16     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  101240003     Medline TA:  Semin Fetal Neonatal Med     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  357-69     Citation Subset:  IM    
Affiliation:
Department of Obstetrics & Gynaecology (Maternal-Fetal Medicine), Mount Sinai Hospital, 600 University Avenue, Toronto, Canada M5G 1X5.
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MeSH Terms
Descriptor/Qualifier:
Female
Fetal Growth Retardation / physiopathology
Humans
Placenta / blood supply,  physiology*,  physiopathology
Placental Insufficiency / etiology,  physiopathology*
Placentation / physiology*
Pregnancy

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