Wang T
Department of Gynecology & Obstetrics, School of Medicine, Jinan University, Guangzhou, China.
Geburtshilfe Frauenheilkd. 1989 Jun;49(6):548-52. doi: 10.1055/s-2008-1035836.
The uterine spiral arteries in humans were examined after a normal course of pregnancy and a pathological course with gestosis, fetal growth retardation and post-term birth. We found that the spiral arterioles in normal pregnancy underwent physiological changes, such as invasion of trophoblasts and decomposition of fibromuscular media and elastic tissue. Apart from the post-term birth, we detected in pathological pregnancies a narrowing of the vascular lumen by proliferation of the intima and often little or no physiological changes of the spiral arterioles in the myometrial segment. Compared to normal pregnancies, thrombogenic formation, swelling of the intima and infiltration of erythrocytes were more frequently observed in post-term births. The flow resistance of maternal blood is greater in cases of gestosis and fetal growth retardation than in normal pregnancies, since the uterine spiral arterioles exhibited a narrowing of the vascular lumen and little or no physiological changes of the vascular wall, and in post-term births also increased thrombogenic formation and swelling of the intima. The resulting decrease in uteroplacental blood flow could lead to a functional insufficiency of the placenta.
对正常妊娠过程以及伴有妊娠中毒症、胎儿生长受限和过期产的病理过程后的人体子宫螺旋动脉进行了检查。我们发现，正常妊娠时螺旋小动脉会发生生理变化，如滋养层细胞浸润以及纤维肌性中膜和弹性组织分解。除过期产外，在病理妊娠中，我们检测到内膜增生导致血管腔狭窄，且子宫肌层段的螺旋小动脉通常很少或没有生理变化。与正常妊娠相比，过期产中血栓形成、内膜肿胀和红细胞浸润更为常见。妊娠中毒症和胎儿生长受限情况下，母体血液的流动阻力比正常妊娠时更大，因为子宫螺旋小动脉出现血管腔狭窄且血管壁很少或没有生理变化，在过期产中还存在血栓形成增加和内膜肿胀。由此导致的子宫胎盘血流量减少可能会导致胎盘功能不全。
