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Inadequate maternal vascular response to placentation in pregnancies complicated by pre‐eclampsia and by small‐for‐gestational age infants
Author(s) -
KHONG T. Y.,
WOLF F.,
ROBERTSON W. B.,
BROSENS I.
Publication year - 1986
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1986.tb07830.x
Subject(s) - placentation , decidua , spiral artery , eclampsia , trophoblast , obstetrics , myometrium , pregnancy , basal plate (neural tube) , gestation , small for gestational age , placenta , third trimester , medicine , biology , uterus , fetus , endocrinology , genetics
Summary. An examination of the maternal vascular response to placentation shows that physiological changes in the placental bed normally extend from the decidua into the inner myometrium. In pre‐eclampsia and in a proportion of pregnancies with small‐for‐gestational age infants (SGA) the physiological changes are restricted to the decidual segments alone. In addition, complete absence of physiological changes throughout the entire length of some spiral arteries is seen in pre‐eclampsia and SGA. This new observation is confirmed in a study of basal plates of placentas from abnormal pregnancies. Intraluminal endovascular trophoblast may be seen in the placental bed spiral arteries in the third trimester in pre‐eclampsia and SGA, a feature not seen beyond the second trimester in normal pregnancy. These findings point to a defect in the normal interaction between migratory trophoblast and maternal uterine tissues in pre‐eclampsia and in SGA.