scholarly journals Remodelling at the maternal–fetal interface: relevance to human pregnancy disorders

Reproduction ◽  
2010 ◽  
Vol 140 (6) ◽  
pp. 803-813 ◽  
Author(s):  
Judith E Cartwright ◽  
Rupsha Fraser ◽  
Karin Leslie ◽  
Alison E Wallace ◽  
Joanna L James
Keyword(s):  
Early Pregnancy ◽  
Immune Cells ◽  
Active Role ◽  
Maternal Blood ◽  
Placental Development ◽  
Successful Pregnancy ◽  
Human Pregnancy ◽  
Healthy Pregnancy ◽  
Maternal Fetal Interface ◽  
Pregnancy Disorders

In human pregnancy, successful placentation and remodelling of the uterine vasculature require the integration of a number of stages, which are crucial for a healthy pregnancy. As the demands of the developing fetus for nutrients and oxygen increase, the capacity of the maternal blood vessels to supply this must be altered radically, with deficiencies in this process implicated in a number of dangerous pregnancy complications. The complex signalling networks that regulate these tightly co-ordinated events are becoming clearer as more studies of early pregnancy are performed. It is the aim of this review to draw together our knowledge of events that occur to facilitate a successful pregnancy ranging from the preparation for implantation, through the invasion and differentiation of the trophoblast and the regulation of these processes by other cells within the decidual environment, to the active role that the trophoblast and maternal immune cells play in facilitating the remodelling of the uterine spiral arteries. The events involved in a healthy pregnancy will then be compared to aberrant placentation and remodelling, which are characteristics of many pregnancy disorders, and recent advances in detection of abnormal placental development will also be discussed.

Can Evolution Inform Insights into Normal and Adverse Pregnancy Outcomes and Ultimately Improve Maternal and Fetal Care?

2019 ◽  
pp. 91-118
Author(s):  
Heide Aungst ◽  
Robert Rossi ◽  
Heather Brockway ◽  
Sam Mesiano ◽  
Louis Muglia
Keyword(s):  
Pregnancy Outcomes ◽  
Reproductive Strategies ◽  
Selection Process ◽  
Adverse Pregnancy Outcomes ◽  
Successful Pregnancy ◽  
General Physiology ◽  
Human Pregnancy ◽  
Healthy Pregnancy ◽  
Challenges And Opportunities ◽  
Adverse Pregnancy

Human survival, like all mammals’, is dependent upon successful pregnancy, the characteristics of which have been subjected to strong evolutionary pressures. This selection process for optimizing reproductive outcomes is unique in that two individuals are affected at the same time, the mother and fetus, and their respective interests may be either congruent or divergent. In this chapter, we provide an overview for considering evolutionary influences on pregnancy, general physiology of human pregnancy, and interactions of the mother and fetus that can either shape a healthy pregnancy or result in complications of pregnancy. Moreover, in considering research into mechanisms of pregnancy maintenance and parturition, we discuss the challenges and opportunities of differing reproductive strategies between species, altering selection in distinct ways, and making pregnancy in women unique amongst mammals.

scholarly journals Maternal Insulin-Like Growth Factors-I and -II Act via Different Pathways to Promote Fetal Growth

Endocrinology ◽  
2006 ◽  
Vol 147 (7) ◽  
pp. 3344-3355 ◽  
Author(s):  
Amanda N. Sferruzzi-Perri ◽  
Julie A. Owens ◽  
Kirsty G. Pringle ◽  
Jeffrey S. Robinson ◽  
Claire T. Roberts
Keyword(s):  
Fetal Growth ◽  
Early Pregnancy ◽  
Guinea Pigs ◽  
Mammalian Species ◽  
Total Surface Area ◽  
Maternal Blood ◽  
Placental Development ◽  
Growth And Survival ◽  
Igf I ◽  
Near Term

The placenta transports substrates and wastes between the maternal and fetal circulations. In mice, placental IGF-II is essential for normal placental development and function but, in other mammalian species, maternal circulating IGF-II is substantial and may contribute. Maternal circulating IGFs increase in early pregnancy, and early treatment of guinea pigs with either IGF-I or IGF-II increases placental and fetal weights by mid-gestation. We now show that these effects persist to enhance placental development and fetal growth and survival near term. Pregnant guinea pigs were infused with IGF-I, IGF-II (both 1 mg/kg·d), or vehicle sc from d 20–38 of pregnancy and killed on d 62 (term = 69 d). IGF-II, but not IGF-I, increased the mid-sagittal area and volume of placenta devoted to exchange by approximately 30%, the total volume of trophoblast and maternal blood spaces within the placental exchange region (+29% and +46%, respectively), and the total surface area of placenta for exchange by 39%. Both IGFs reduced resorptions, and IGF-II increased the number of viable fetuses by 26%. Both IGFs increased fetal weight by 11–17% and fetal circulating amino acid concentrations. IGF-I, but not IGF-II, reduced maternal adipose depot weights by approximately 30%. In conclusion, increased maternal IGF-II abundance in early pregnancy promotes fetal growth and viability near term by increasing placental structural and functional capacity, whereas IGF-I appears to divert nutrients from the mother to the conceptus. This suggests major and complementary roles in placental and fetal growth for increased circulating IGFs in early to mid-pregnancy.

scholarly journals Placenta-Derived Exosomes as a Modulator in Maternal Immune Tolerance During Pregnancy

2021 ◽  
Vol 12 ◽  
Author(s):  
Kunfeng Bai ◽  
Xintong Li ◽  
Jiangming Zhong ◽  
Ernest H. Y. Ng ◽  
William S.B. Yeung ◽  
...  
Keyword(s):  
Immune Tolerance ◽  
Immune Cells ◽  
Average Diameter ◽  
Underlying Mechanism ◽  
Maternal Blood ◽  
Molecular Signatures ◽  
Successful Pregnancy ◽  
Dependent Pathway ◽  
Potential Biomarkers ◽  
In Pregnancy

Exosomes are a subset of extracellular vesicles with an average diameter of ~100nm. Exosomes are released by all cells through an endosome-dependent pathway and carry nucleic acids, proteins, lipids, cytokines and metabolites, mirroring the state of the originating cells. The function of exosomes has been implicated in various reproduction processes, such as embryo development, implantation, decidualization and placentation. Placenta-derived exosomes (pEXO) can be detected in the maternal blood as early as 6 weeks after conception and their levels increase with gestational age. Importantly, alternations in the molecular signatures of pEXO are observed in pregnancy-related complications. Thus, these differentially expressed molecules could be the potential biomarkers for diagnosis of the pregnancy-associated diseases. Recent studies have demonstrated that pEXO play a key role in the establishment of maternal immune tolerance, which is critical for a successful pregnancy. To gain a better understanding of the underlying mechanism, we highlighted the advanced studies of pEXO on immune cells in pregnancy.

210. Localisation of insulin-like growth factor-II (IGF-II) and its receptor in early murine pregnancy: a role in placentation and angiogenesis in the decidua?

2005 ◽  
Vol 17 (9) ◽  
pp. 80
Author(s):  
K. G. Pringle ◽  
C. T. Roberts
Keyword(s):  
Blood Vessels ◽  
Early Pregnancy ◽  
Close Contact ◽  
Protein S ◽  
Giant Cells ◽  
Maternal Blood ◽  
Extravillous Trophoblast ◽  
Placental Development ◽  
Direct Role ◽  
Intracellular Signalling Pathway

The highly invasive activity of the human placenta is tightly regulated by a variety of growth factors and other molecules. Contrary to the dominant view, recent data suggests that IGF-II, upon binding to the IGF2R, can stimulate an intracellular signalling pathway.1 Evidence in humans and mice suggests that IGF-II and the IGF2R are important regulators of placental growth; however, to date they have not yet been localised to early murine implantation sites. This study provides a photo micrographic account of early placental development and the decidual vasculature in the mouse, and localises IGF-II and the IGF2R from days 5.5 to 10.5 of pregnancy. During early pregnancy, the decidua displays a paucity of blood vessels, which appear to undergo angiogenesis, so that by day 10.5 the decidua has become a highly vascularized structure, with an extensive network of dilated vessels that presumably enable maximal blood supply to the placenta. Unlike humans, murine trophoblast cells do not invade the endometrium individually, but remain in close contact with the main giant cell layer. The trophoblast giant cells (TGCs) are the outermost cell type of the murine placenta and maternal blood spaces beneath this layer are not lined by endothelium. Due to their location, TGCs appear to play a direct role in displacing this endothelium and therefore may play a role in the transformation into trophoblast lined maternal blood spaces. IGF-II and its receptor were present throughout early pregnancy in the conceptus and maternal decidua supporting their role as regulators of fetal and placental development. Most interesting, however, was their association with the developing maternal blood vessels in the mesometrial decidua. It seems likely that in mice the maternal vessels are remodelled by a variety of locally derived molecules. By association, IGF-II and its receptor are likely candidates. (1)McKinnon T, et al. (2001). Stimulation of human extravillous trophoblast migration by IGF-II is mediated by IGF type 2 receptor involving inhibitory G protein(s) and phosphorylation of MAPK. J. Clin. Endocrinol. Metab. 86(8), 3665–3674.

scholarly journals A Potential Role and Contribution of Androgens in Placental Development and Pregnancy

Life ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 644
Author(s):  
Agata M. Parsons ◽  
Gerrit J. Bouma
Keyword(s):  
Fetal Development ◽  
Fetal Loss ◽  
Membrane Receptors ◽  
Placental Development ◽  
Placental Function ◽  
Fetal Physiology ◽  
Estrogen Synthesis ◽  
And Function ◽  
Pregnancy Disorders

Successful pregnancy requires the establishment of a highly regulated maternal–fetal environment. This is achieved through the harmonious regulation of steroid hormones, which modulate both maternal and fetal physiology, and are critical for pregnancy maintenance. Defects in steroidogenesis and steroid signaling can lead to pregnancy disorders or even fetal loss. The placenta is a multifunctional, transitory organ which develops at the maternal–fetal interface, and supports fetal development through endocrine signaling, the transport of nutrients and gas exchange. The placenta has the ability to adapt to adverse environments, including hormonal variations, trying to support fetal development. However, if placental function is impaired, or its capacity to adapt is exceeded, fetal development will be compromised. The goal of this review is to explore the relevance of androgens and androgen signaling during pregnancy, specifically in placental development and function. Often considered a mere precursor to placental estrogen synthesis, the placenta in fact secretes androgens throughout pregnancy, and not only contains the androgen steroid nuclear receptor, but also non-genomic membrane receptors for androgens, suggesting a role of androgen signaling in placental function. Moreover, a number of pregnancy disorders, including pre-eclampsia, gestational diabetes, intrauterine growth restriction, and polycystic ovarian syndrome, are associated with abnormal androgen levels and androgen signaling. Understanding the role of androgens in the placenta will provide a greater understanding of the pathophysiology of pregnancy disorders associated with androgen elevation and its consequences.

scholarly journals Placental development during early pregnancy in sheep: Effects of embryo origin on fetal and placental growth and global methylation

2013 ◽  
Vol 79 (1) ◽  
pp. 94-102 ◽  
Author(s):  
Anna T. Grazul-Bilska ◽  
Mary Lynn Johnson ◽  
Pawel P. Borowicz ◽  
Loren Baranko ◽  
Dale A. Redmer ◽  
...  
Keyword(s):  
Early Pregnancy ◽  
Placental Development ◽  
Global Methylation ◽  
Embryo Origin

scholarly journals Objective assessment of alcohol consumption in early pregnancy using phosphatidylethanol: a cross‐sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Leonieke J. Breunis ◽  
Sophie Wassenaar ◽  
Barbara J. Sibbles ◽  
Ab A. Aaldriks ◽  
Hilmar H. Bijma ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Early Pregnancy ◽  
Gestational Age ◽  
Care Provider ◽  
Objective Assessment ◽  
Obstetric Care ◽  
Tertiary Hospital ◽  
Maternal Blood ◽  
Added Value ◽  
Cross Sectional

Abstract Background Alcohol consumption during pregnancy is associated with major birth defects and developmental disabilities. Questionnaires concerning alcohol consumption during pregnancy underestimate alcohol use while the use of a reliable and objective biomarker for alcohol consumption enables more accurate screening. Phosphatidylethanol can detect low levels of alcohol consumption in the previous two weeks. In this study we aimed to biochemically assess the prevalence of alcohol consumption during early pregnancy using phosphatidylethanol in blood and compare this with self-reported alcohol consumption. Methods To evaluate biochemically assessed prevalence of alcohol consumption during early pregnancy using phosphatidylethanol levels, we conducted a prospective, cross-sectional, single center study in the largest tertiary hospital of the Netherlands. All adult pregnant women who were under the care of the obstetric department of the Erasmus MC and who underwent routine blood testing at a gestational age of less than 15 weeks were eligible. No specified informed consent was needed. Results The study was conducted between September 2016 and October 2017. In total, we received 1,002 residual samples of 992 women. After applying in- and exclusion criteria we analyzed 684 samples. Mean gestational age of all included women was 10.3 weeks (SD 1.9). Of these women, 36 (5.3 %) tested positive for phosphatidylethanol, indicating alcohol consumption in the previous two weeks. Of women with a positive phosphatidylethanol test, 89 % (n = 32) did not express alcohol consumption to their obstetric care provider. Conclusions One in nineteen women consumed alcohol during early pregnancy with a high percentage not reporting this use to their obstetric care provider. Questioning alcohol consumption by an obstetric care provider did not successfully identify (hazardous) alcohol consumption. Routine screening with phosphatidylethanol in maternal blood can be of added value to identify women who consume alcohol during pregnancy.

Endocrine and metabolic adaptations to pregnancy; impact of obesity

2015 ◽  
Vol 24 (1) ◽  
Author(s):  
Sylvie Hauguel-de Mouzon ◽  
Luciana Lassance
Keyword(s):  
Metabolic Disease ◽  
Insulin Action ◽  
Maternal Obesity ◽  
Normal Pregnancy ◽  
Metabolic Homeostasis ◽  
Insulin Production ◽  
Successful Pregnancy ◽  
Healthy Pregnancy ◽  
Metabolic Adaptations ◽  
In Pregnancy

AbstractAdaptations of maternal endocrine and metabolic homeostasis are central to successful pregnancy. They insure that an adequate and continuous supply of metabolic fuels is available for the growing fetus. Healthy pregnancy is classically described as a mild diabetogenic state with significant adjustments in both insulin production and sensitivity. The placenta contributes to the endocrine adaptations to pregnancy through the synthesis of various hormones which may impact insulin action. Obesity has the highest prevalence among metabolic disease in pregnancy. This article summarizes the literature addressing the endocrine and metabolic adaptations implemented during normal pregnancy. Mechanisms of regulation are further examined in the context of maternal obesity.

scholarly journals Prediction of Healthy Pregnancy Outcomes in Women with Overweight and Obesity: The Role of Maternal Early-Pregnancy Metabolites

Metabolites ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 13
Author(s):  
Rama J. Wahab ◽  
Vincent W. V. Jaddoe ◽  
Romy Gaillard
Keyword(s):  
Pregnancy Outcome ◽  
Early Pregnancy ◽  
Pregnancy Outcomes ◽  
Gestational Hypertension ◽  
Characteristic Curve ◽  
Overweight And Obesity ◽  
Large For Gestational Age ◽  
Maternal Characteristics ◽  
Healthy Pregnancy ◽  
Increased Risk

Women with obesity receive intensified antenatal care due to their increased risk of pregnancy complications, even though not all of these women develop complications. We developed a model based on maternal characteristics for prediction of healthy pregnancy outcomes in women with obesity or who are overweight. We assessed whether early-pregnancy metabolites improved prediction. In a population-based cohort study among a subsample of 1180 Dutch pregnant women with obesity or who are overweight, we developed a prediction model using 32 maternal socio-demographic, lifestyle, physical and pregnancy-related characteristics. We determined early-pregnancy amino acids, nonesterifed fatty acids, phospholipids and carnitines in blood serum using liquid chromatography-tandem mass spectrometry. A healthy pregnancy outcome was the absence of fetal death, gestational hypertension, preeclampsia, gestational diabetes, caesarian section, preterm birth, large-for-gestational-age at birth, macrosomia, postpartum weight retention and offspring overweight/obesity at 5 years. Maternal age, relationship status, parity, early-pregnancy body mass index, mid-pregnancy gestational weight gain, systolic blood pressure and estimated fetal weight were selected into the model using backward selection (area under the receiver operating characteristic curve: 0.65 (95% confidence interval 0.61 to 0.68)). Early-pregnancy metabolites did not improve model performance. Thus, in women with obesity or who are overweight, maternal characteristics can moderately predict a healthy pregnancy outcome. Maternal early-pregnancy metabolites have no incremental value in the prediction of a healthy pregnancy outcome.

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