Journal
JOURNAL OF PERINATAL MEDICINE
Volume 34, Issue 6, Pages 447-458Publisher
WALTER DE GRUYTER GMBH
DOI: 10.1515/JPM.2006.089
Keywords
atherosis; immunohistochemistry; impedance to blood flow; integrin; physiologic transformation of the spiral arteries; placental bed
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Funding
- Intramural NIH HHS [Z01 HD002400] Funding Source: Medline
- EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT [ZIAHD002400] Funding Source: NIH RePORTER
- EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH &HUMAN DEVELOPMENT [Z01HD002400] Funding Source: NIH RePORTER
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This article reviews the anatomy and physiology of the uterine circulation, with emphasis on the remodeling of spiral arteries during normal pregnancy, and the timing and anatomical pathways of trophoblast invasion of the spiral arteries. We review the definitions of the placental bed and basal plate of the placenta, their relevance to the study of the physiologic transformation of the spiral arteries, as well as the methods to obtain and examine placental bed biopsy specimens. We also examine the role of the extravillous trophoblast in normal and abnormal pregnancies, and the criteria used to diagnose failure of physiologic transformation of the spiral arteries. Finally, we comment on the use of uterine artery Doppler velocimetry as a surrogate marker of chronic uteroplacental ischemia.
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