Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, The Netherlands.
Best Pract Res Clin Obstet Gynaecol. 2011 Jun;25(3):259-71. doi: 10.1016/j.bpobgyn.2010.10.011. Epub 2010 Dec 8.
The timing of decidualisation and vascular processes during the implantation period is of paramount importance for the development of a receptive endometrium suitable for implantation. The endometrium transforms during the secretory phase into a well-vascularised receptive tissue characterised by increased vascular permeability, oedema, proliferation and differentiation of stromal cells into decidual cells, invasion of leucocytes, vascular remodelling and angiogenesis. Decidualisation continues in the presence of conception and an influx of immune cells, trophoblasts and vascular adaptation will occur. Vascular changes include spiral artery remodelling, angiogenesis and the induction of angiogenic factors. Disturbances in uterine blood supply are associated with first-trimester miscarriages and third-trimester perinatal morbidity and mortality caused by pre-eclampsia and foetal growth restriction. This article assesses decidual vascular changes during human implantation, and evaluates the involvement of angiogenesis in the pathogenesis of miscarriages, pre-eclampsia and intrauterine growth restriction.
在着床期，蜕膜化和血管过程的时间安排对适合着床的接受性子宫内膜的发育至关重要。在分泌期，子宫内膜转化为富含血管的接受性组织，其特征是血管通透性增加、水肿、基质细胞向蜕膜细胞的增殖和分化、白细胞浸润、血管重塑和血管生成。如果怀孕，蜕膜化会继续进行，免疫细胞、滋养层细胞的涌入以及血管适应都会发生。血管变化包括螺旋动脉重塑、血管生成和血管生成因子的诱导。子宫血液供应的紊乱与早期流产以及子痫前期和胎儿生长受限引起的晚期围产期发病率和死亡率有关。本文评估了人类着床过程中蜕膜血管的变化，并评估了血管生成在流产、子痫前期和宫内生长受限发病机制中的作用。
