1 Department of Obstetrics and Gynecology, Divisions of Maternal Fetal Medicine and Reproductive Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
2 Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Reprod Sci. 2017 May;24(5):753-761. doi: 10.1177/1933719116669056. Epub 2016 Oct 12.
The uterine vasculature undergoes marked changes during pregnancy in order to provide the necessary increase in blood flow to support growth and nutrition of the uterus, placenta, and developing fetus. Pregnancy-associated uterine vascular transformations are orchestrated by a complex array of endocrine and cellular mechanisms to bring about structural modifications at the maternal-fetal interface, which collectively lead to development of the uteroplacental circulation. Understanding intrinsic uterine vascular remodeling in pregnancy is essential for understanding the physiologic and pathophysiologic regulation of maternal uterine blood flow. Aberrations of uterine vascular remodeling are potentially involved in the etiology of several pregnancy disorders, for example, preeclampsia, fetal growth restriction, and preterm labor; therefore, it is essential for subspecialist clinicians and investigators interested in reproductive physiology to fully understand the establishment of uteroplacental circulation. The foundational literature in this area is extensive; thus, a succinct review is likely to be a useful resource. Herein, we present and discuss a historical perspective on uterine vascular anatomy, maternal vascular growth associated with decidualization, trophoblast invasion, intervillous circulation, aberrations in uterine vascular modeling, and the clinical implications of improper development of the uteroplacental circulation.
子宫血管系统在怀孕期间会发生明显变化，以提供必要的血流增加，为子宫、胎盘和发育中的胎儿提供生长和营养。妊娠相关的子宫血管转化是由一系列复杂的内分泌和细胞机制协调的，这些机制导致了母体-胎儿界面的结构改变，共同导致了胎盘循环的发展。了解妊娠期间内在的子宫血管重塑对于理解母体子宫血流的生理和病理调节至关重要。子宫血管重塑的异常可能与几种妊娠疾病的病因有关，例如子痫前期、胎儿生长受限和早产；因此，对生殖生理学感兴趣的专科临床医生和研究人员充分了解胎盘循环的建立是至关重要的。该领域的基础文献非常广泛；因此，简洁的综述可能是一个有用的资源。在此，我们介绍和讨论了子宫血管解剖学的历史观点、与蜕膜化相关的母体血管生长、滋养细胞浸润、绒毛间循环、子宫血管建模异常以及胎盘循环发育不当的临床意义。
