Placental-related diseases of pregnancy: involvement of oxidative stress and implications in human evolution
By Eric Jauniaux, L. Poston, G. Burton. Human Reproduction Update, 2006
623 citations recorded by the source corpus.
Miscarriage and pre-eclampsia are the most common disorders of human pregnancy. Both are placental-related and exceptional in other mammalian species. Ultrasound imaging has enabled events during early pregnancy to be visualized in vivo for the first time. As a result, a new understanding of the early materno–fetal relationship has emerged and, with it, new insight into the pathogenesis of these disorders. Unifying the two is the concept of placental oxidative stress, with associated necrosis and apoptosis of the trophoblastic epithelium of the placental villous tree. In normal pregnancies, the earliest stages of development take place in a low oxygen (O2) environment. This physiological hypoxia of the early gestational sac protects the developing fetus against the deleterious and teratogenic effects of O2 free radicals (OFRs). In miscarriage, development of the placento–decidual interface is severely impaired leading to early and widespread onset of maternal blood flow and major oxidative degeneration. This mechanism is common to all miscarriages, with the time at which it occurs in the first trimester depending on the aetiology. In contrast, in pre-eclampsia the trophoblastic invasion is sufficient to allow early pregnancy phases of placentation but too shallow for complete transformation of the arterial utero–placental circulation, predisposing to a repetitive ischaemia–reperfusion (I/R) phenomenon. We suggest that pre-eclampsia is a three-stage disorder with the primary pathology being an excessive or atypical maternal immune response. This would impair the placentation process leading to chronic oxidative stress in the placenta and finally to diffuse maternal endothelial cell dysfunction.
Subfields: Immunology, Obstetrics and Gynecology, Pediatrics, Perinatology and Child Health
View Paper: https://www.semanticscholar.org/paper/17f9406eec73d7d5dc73ae1abc752e208676395a
How researchers see this paper
The researchers whose trusted networks rank it highest, strongest advocate first. Every researcher gets a different order.
In Immunology
In Obstetrics and Gynecology
In Pediatrics, Perinatology and Child Health
Citations in the corpus
- Immunology of placentation in eutherian mammals (2006, background): “By contrast, in human haemochorial placentation, there is lowering of resistance in the vessels of the placental bed caused by modification of the walls of pre-existing arteries, resulting in increased low-pressure blood flo”
- Pathophysiology of placental‐derived fetal growth restriction (2018, background): “pathophysiological roots in the early stages of placentation and can manifest themselves from the end of the first trimester of pregnancy when the definitive placenta is forming.(14,15) Considerable remodeling of the placenta takes place toward the end of the first trimester/start of the second trim”