Huppertz Berthold, Weiss Gregor, Moser Gerit
Institute of Cell Biology, Histology and Embryology, Medical University of Graz, Austria.
Institute of Cell Biology, Histology and Embryology, Medical University of Graz, Austria.
J Reprod Immunol. 2014 Mar;101-102:74-79. doi: 10.1016/j.jri.2013.04.003. Epub 2013 Jun 6.
Invasion of extravillous trophoblast into maternal tissues has a profound effect on the oxygenation of the placenta and hence the fetus. The main route of trophoblast invasion is interstitial invasion into the tissues of the decidua and myometrium. From this main route side branches reach the spiral arteries (endovascular trophoblast) as well as the uterine glands (endoglandular trophoblast) to open both structures toward the intervillous space. This enables histiotrophic nutrition in the first trimester and hemotrophic nutrition in the second and third trimesters of pregnancy. Failure of endovascular trophoblast invasion has profound effects on the oxygenation of the placenta. Interestingly, this does not lead to hypoxia as has long been presumed. Rather, all measurements available today point to increased oxygen levels within the placenta in patients with a failure of spiral artery transformation. This should lead to a rethink regarding pathological conditions such as intrauterine growth restriction and preeclampsia.
绒毛外滋养层细胞侵入母体组织对胎盘乃至胎儿的氧合作用具有深远影响。滋养层细胞侵入的主要途径是间质侵入蜕膜和子宫肌层组织。从这一主要途径发出的分支到达螺旋动脉（血管内滋养层细胞）以及子宫腺（腺内滋养层细胞），使这两种结构都向绒毛间隙开放。这使得在妊娠早期能够进行组织营养，在妊娠中期和晚期能够进行血液营养。血管内滋养层细胞侵入失败对胎盘的氧合作用有深远影响。有趣的是，这并不会像长期以来所推测的那样导致缺氧。相反，如今所有可用的测量结果都表明，螺旋动脉转化失败的患者胎盘内的氧水平升高。这应该促使人们对诸如宫内生长受限和先兆子痫等病理状况进行重新思考。
