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The potential perinatal origin of placentation disorders in the young primigravida
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Brosens, Jan J., Benagiano, Giuseppe and Brosens, Ivo (2015) The potential perinatal origin of placentation disorders in the young primigravida. American Journal of Obstetrics and Gynecology, Volume 212 (Number 5). pp. 580-585. doi:10.1016/j.ajog.2015.01.013 ISSN 0002-9378.
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Official URL: http://dx.doi.org/10.1016/j.ajog.2015.01.013
Abstract
The fetus is exposed to high plasma concentrations of unbound estrogens and progesterone throughout pregnancy. However, secretory or decidual changes in the fetal uterus occur relatively infrequently before birth, suggesting a variable endometrial progesterone response at the time of birth. Arguably, partial progesterone resistance that persists into adolescent years may compromise the physiological transformation of the spiral arteries and predispose for defective placentation in the case of pregnancy. Decidualization of the endometrial stromal compartment and junctional zone myometrium precedes trophoblast invasion. It represents the first step in the process of spiral artery remodeling needed to establish effective uteroplacental blood flow by midpregnancy. The major obstetric syndromes caused by impaired placental bed spiral artery remodeling are prevalent in teenage pregnancies, including preeclampsia, fetal growth restriction, and spontaneous preterm labor. Preconditioning of the uterus in response to cyclic menstruation during adolescence may be critical to achieve full uterine responsiveness to hormonal cues. Understanding the mechanisms of functional maturation of the uterus during the early reproductive years may yield novel insights into the major obstetric syndromes.
Item Type: | Journal Article | ||||||||||
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Subjects: | R Medicine > RG Gynecology and obstetrics | ||||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences > Translational & Experimental Medicine > Reproductive Health ( - until July 2016) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | Obstetrics -- Research, Progesterone, Decidua | ||||||||||
Journal or Publication Title: | American Journal of Obstetrics and Gynecology | ||||||||||
Publisher: | Mosby-Elsevier | ||||||||||
ISSN: | 0002-9378 | ||||||||||
Official Date: | May 2015 | ||||||||||
Dates: |
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Volume: | Volume 212 | ||||||||||
Number: | Number 5 | ||||||||||
Page Range: | pp. 580-585 | ||||||||||
DOI: | 10.1016/j.ajog.2015.01.013 | ||||||||||
Status: | Peer Reviewed | ||||||||||
Publication Status: | Published | ||||||||||
Access rights to Published version: | Restricted or Subscription Access |
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