Kadyrov Mamed, Kingdom John C P, Huppertz Berthold
Department of Anatomy II, University Hospital, Aachen, Germany.
Am J Obstet Gynecol. 2006 Feb;194(2):557-63. doi: 10.1016/j.ajog.2005.07.035.
Impaired trophoblast invasion into spiral arteries is associated with early-onset intrauterine growth restriction and preeclampsia. We compared trophoblast invasion into spiral arteries in pregnancies with maternal anemia or early-onset preeclampsia/intrauterine growth restriction and related these findings to trophoblast apoptosis.
Full-thickness uterine wall samples were obtained from women with early-onset preeclampsia/intrauterine growth restriction (n = 6), normal pregnancies (n = 5), and chronic anemia (n = 8). Trophoblast invasion into the walls of spiral arteries was quantified by morphometric analysis of paraffin sections stained with anticytokeratin 18, antiactin, and anticytokeratin 18 neoepitope (M30) antibodies.
Trophoblast invasion into spiral arteries was increased in anemic pregnancies (mean [SD]: 206 [46] cell profiles/mm2) and severely impaired in preeclamptic/intrauterine growth restriction pregnancies (17 [6]), compared with normal subjects (149 [52]). Spiral artery lumen area was increased in anemia (0.07 [0.03] mm2) versus normal pregnancies (0.09 [0.04] mm2) and reduced in preeclampsia/intrauterine growth restriction (0.04 [0.02] mm2). Trophoblast apoptosis was similar in anemic (4.2% [3.4%]) and normal (5.0% [1.9%]) pregnancies but increased in preeclampsia/intrauterine growth restriction (12% [5.6%]).
Trophoblast invasion into the placental bed in early-onset preeclampsia/intrauterine growth restriction is limited by increased apoptosis, resulting in narrower spiral arteries, which is in contrast to findings in anemia.
滋养层细胞侵入螺旋动脉受损与早发型子宫内生长受限及先兆子痫有关。我们比较了患有母体贫血或早发型先兆子痫/子宫内生长受限的孕妇中滋养层细胞侵入螺旋动脉的情况，并将这些发现与滋养层细胞凋亡相关联。
从患有早发型先兆子痫/子宫内生长受限（n = 6）、正常妊娠（n = 5）和慢性贫血（n = 8）的女性中获取全层子宫壁样本。通过对用抗细胞角蛋白18、抗肌动蛋白和抗细胞角蛋白18新表位（M30）抗体染色的石蜡切片进行形态计量分析，对滋养层细胞侵入螺旋动脉壁的情况进行量化。
与正常受试者（149 [52]）相比，贫血孕妇中滋养层细胞侵入螺旋动脉的情况增加（平均值[标准差]：206 [46]个细胞剖面/mm²），而先兆子痫/子宫内生长受限孕妇中则严重受损（17 [6]）。贫血时螺旋动脉管腔面积增加（0.07 [0.03] mm²），而正常妊娠时为（0.09 [0.04] mm²），先兆子痫/子宫内生长受限时则减小（0.04 [0.02] mm²）。贫血（4.2% [3.4%]）和正常（5.0% [1.9%]）妊娠中滋养层细胞凋亡情况相似，但先兆子痫/子宫内生长受限时增加（12% [5.6%]）。
早发型先兆子痫/子宫内生长受限中滋养层细胞侵入胎盘床受到凋亡增加的限制，导致螺旋动脉变窄，这与贫血中的发现相反。
