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Circulation Journal : Official Journal... Dec 2021Pregnant women with a Fontan circulation have a high risk of obstetric complications, such as preterm delivery and small for gestational age (SGA), which may be affected...
BACKGROUND
Pregnant women with a Fontan circulation have a high risk of obstetric complications, such as preterm delivery and small for gestational age (SGA), which may be affected by low blood flow to the placenta and hypoxia. This study investigated placental pathology in a Fontan circulation.Methods and Results:Eighteen pregnancies in 11 women with a Fontan circulation were reviewed. Pregnancy outcomes showed 9 miscarriages and 9 live births, with 4 preterm deliveries. Five neonates were SGA (<5th percentile). Eight placentas from live births in 7 women were available for the study. Five placentas had low weight placenta for gestational age, and 7 grossly showed a chronic subchorionic hematoma. Histological examination revealed all placentas had some form of histological hypoxic lesions: maternal vascular malperfusion in 7, fetal vascular malperfusion in 1, and other hypoxia-related lesions in 8. Quantitative analyses, including immunohistochemistry (CD31, CD68, and hypoxia inducible factor-1α antibodies) and Masson's trichrome staining, were also performed and compared with 5 control placentas. Capillary density and the area of fibrosis were significantly greater in placentas from women with a Fontan circulation than in control placentas.
CONCLUSIONS
Placentas in a Fontan circulation were characterized by a high frequency of low placental weight, chronic subchorionic hematoma, and constant histological hypoxic changes, which could reflect altered maternal cardiac conditions and lead to poor pregnancy outcomes.
Topics: Child; Female; Fetal Growth Retardation; Fontan Procedure; Hematoma; Humans; Hypoxia; Infant, Newborn; Infant, Small for Gestational Age; Placenta; Pregnancy
PubMed: 34497162
DOI: 10.1253/circj.CJ-21-0133 -
Philosophical Transactions of the Royal... Mar 2015The placenta is one of the most morphologically variable mammalian organs. Four major characteristics are typically discussed when comparing the placentas of different... (Review)
Review
The placenta is one of the most morphologically variable mammalian organs. Four major characteristics are typically discussed when comparing the placentas of different eutherian species: placental shape, maternal-fetal interdigitation, intimacy of the maternal-fetal interface and the pattern of maternal-fetal blood flow. Here, we describe the evolution of three of these features as well as other key aspects of eutherian placentation. In addition to interspecific anatomical variation, there is also variation in placental anatomy and function within a single species. Much of this intraspecific variation occurs in response to different environmental conditions such as altitude and poor maternal nutrition. Examinations of variation in the placenta from both intra- and interspecies perspectives elucidate different aspects of placental function and dysfunction at the maternal-fetal interface. Comparisons within species identify candidate mechanisms that are activated in response to environmental stressors ultimately contributing to the aetiology of obstetric syndromes such as pre-eclampsia. Comparisons above the species level identify the evolutionary lineages on which the potential for the development of obstetric syndromes emerged.
Topics: Animals; Biological Evolution; Female; Mammals; Maternal-Fetal Exchange; Obstetric Labor Complications; Placenta; Pregnancy; Species Specificity
PubMed: 25602076
DOI: 10.1098/rstb.2014.0072 -
Placenta Mar 2016Telomeres are nucleoprotein structures located at the termini of chromosomes. They are essential for chromosome stability. Telomeres become shorter due to mitotic cycles... (Review)
Review
Telomeres are nucleoprotein structures located at the termini of chromosomes. They are essential for chromosome stability. Telomeres become shorter due to mitotic cycles and environmental factors. When telomeres are shortened and therefore dysfunctional, cellular senescence occurs and organ dysfunction might develop. During pregnancy, fetal growth restriction secondary to placental insufficiency has been linked to impaired telomere homeostasis in which telomeres are shorter, telomerase is decreased, and compensatory mechanisms of telomere capture are enhanced. These characteristics, along with increased signs of senescence, indicate telomere dysfunction in trophoblasts from placentas affected by intrauterine growth restriction (IUGR). This review summarizes the information currently available regarding telomere homeostasis in trophoblasts from human pregnancies affected by IUGR. Improved understanding of placental physiology might help in the development of treatment options for fetuses with IUGR.
Topics: Animals; Female; Fetal Growth Retardation; Humans; Placenta; Pregnancy; Telomere; Telomere Homeostasis
PubMed: 26992670
DOI: 10.1016/j.placenta.2015.11.006 -
Placenta Dec 2021Gestational diabetes mellitus (GDM) is defined as diabetes with onset or first recognition during gestation. It is a common complication of pregnancy that has become... (Review)
Review
Gestational diabetes mellitus (GDM) is defined as diabetes with onset or first recognition during gestation. It is a common complication of pregnancy that has become more prevalent over the past few decades. Abnormalities in fetal growth, including increased incidence of both large and small for gestational age babies, suggest placental dysfunction. The major goal of this scoping review is to determine what is known about abnormalities in placentas delivered from GDM pregnancies, and how early in gestation these abnormalities arise. A secondary goal is to review to what extent other selected factors, in particular obesity, have been found to influence or modify the reported effects of GDM on placental development, and whether these are considered in the study of GDM placentas. PubMed and Scopus databases were searched using the key terms: "gestational diabetes AND (woman OR human) AND placenta AND (ultrasound OR ultrastructure OR imaging OR histology OR pathology). Studies of gross morphology and histoarchitecture in placentas delivered from GDM pregnancies consistently report increased placental size, villous immaturity and a range of vascular lesions when compared to uncomplicated pregnancies. In contrast, a small number of ultrasound studies have examined placental development in GDM pregnancies in the second, and especially, the first trimester. Relatively few studies have analyzed interactions with maternal BMI, but these do suggest that it may play a role in placental abnormalities. Further examination of placental development early in pregnancy is needed to understand when it becomes disrupted in GDM, as a first step to identifying the underlying causes.
Topics: Diabetes, Gestational; Female; Humans; Placenta; Pregnancy; Ultrasonography, Prenatal
PubMed: 33958235
DOI: 10.1016/j.placenta.2021.04.005 -
Yi Chuan = Hereditas May 2016The cloning technique, also called somatic cell nuclear transfer (SCNT), has been successfully established and gradually applied to various mammalian species. However,... (Review)
Review
The cloning technique, also called somatic cell nuclear transfer (SCNT), has been successfully established and gradually applied to various mammalian species. However, the developmental rate of SCNT mammalian embryos is very low, usually at 1% to 5%, which limits the application of SCNT. Placental developmental defects are considered as the main cause of SCNT embryo development inhibition. Almost all of SCNT-derived mammalian placentas exhibit various abnormalities, such as placental hyperplasia, vascular defects and umbilical cord malformation. Mechanistically, these abnormalities result from failure of establishment of correct epigenetic modification in the trophectoderm genome, which leads to erroneous expression of important genes for placenta development-related, particularly imprinted genes. Consequently, aberrant imprinted gene expression gives rise to placental morphologic abnormalities and functional defects, therefore decreases developmental competence of cloned embryos. Currently, although numerous methods that can improve the developmental ability of SCNT-derived embryos have been reported, most of them are unable to substantially enhance the success rate of SCNT due to failure to eliminate the placental development defects. In this review, we summarize placental abnormalities and imprinted gene expression in mammalian cloning, and propose directions for the future research aiming to improve the cloning efficiency.
Topics: Animals; Embryo, Mammalian; Embryonic Development; Female; Genomic Imprinting; Nuclear Transfer Techniques; Placenta; Pregnancy; Umbilical Cord
PubMed: 27232488
DOI: 10.16288/j.yczz.15-466 -
Cellular and Molecular Life Sciences :... Jan 2016Preeclampsia is a hypertensive disease that complicates many pregnancies, typically presenting with new-onset or worsening hypertension and proteinuria. It is well... (Review)
Review
Preeclampsia is a hypertensive disease that complicates many pregnancies, typically presenting with new-onset or worsening hypertension and proteinuria. It is well recognized that the placental syncytium plays a key role in the pathogenesis of preeclampsia. This review summarizes the findings pertaining to the structural alterations in the syncytium of preeclamptic placentas and analyzes their pathological implications for the development of preeclampsia. Changes in the trophoblastic lineage, including those in the proliferation of cytotrophoblasts, the formation of syncytiotrophoblast through cell fusion, cell apoptosis and syncytial deportation, are discussed in the context of preeclampsia. Extensive correlations are made between functional deficiencies and the alterations on the levels of gross anatomy, tissue histology, cellular events, ultrastructure, molecular pathways, and gene expression. Attention is given to the significance of dynamic changes in the syncytial turnover in preeclamptic placentas. Specifically, experimental evidences for the complex and obligatory role of syncytin-1 in cell fusion, cell-cycle regulation at the G1/S transition, and apoptosis through AIF-mediated pathway, are discussed in detail in the context of syncytium homeostasis. Finally, the recent observations on the aberrant fibrin deposition in the trophoblastic layer and the trophoblast immature phenotype in preeclamptic placentas and their potential pathogenic impact are also reviewed.
Topics: Animals; Apoptosis; Cell Fusion; Cell Proliferation; Female; Gene Products, env; Giant Cells; Humans; Placenta; Pre-Eclampsia; Pregnancy; Pregnancy Proteins; Trophoblasts
PubMed: 26496726
DOI: 10.1007/s00018-015-2069-x -
Progress in Molecular Biology and... 2017Trophoblasts, a major constituent of the placenta, are known to express genes derived from various endogenous retroviruses (ERVs) as well as LTR retrotransposons.... (Review)
Review
Trophoblasts, a major constituent of the placenta, are known to express genes derived from various endogenous retroviruses (ERVs) as well as LTR retrotransposons. However, the evolutionary significance of ERV-derived genes involved in placental development has not been well characterized. In this review, we catalog the diverse morphology of placental structure among mammalian species with note of counterintuitive developments. We then detail the history of ancient placenta development with paternally expressed gene 10 (Peg10/Sirh1), Peg11/Sirh2, and Sirh7/Ldoc1 as LTR retrotransposons, followed by independent captures of ERV-env-related genes such as Syncytin-1, -2, -A, -B, -Rum1, and Fematrin-1 responsible for trophoblast cell fusion, resulting in multinucleate syncytiotrophoblast formation, and possibly morphological diversification of placentas. Because the endogenization of retroviral infections has occurred multiple times independently in different mammalian lineages, and some use the same molecules in their transcriptional activation, we speculate that ERV gene variants integrated into mammalian genomes in a locus-specific manner have replaced the genes previously responsible for cell fusion. Moreover, ERVs also work as transcriptional regulators of various genes such as interferon (IFN)-stimulated genes. The "baton pass" hypothesis suggests that evolutionary events caused by multiple successive retrotransposon integrations, possibly resulting in effective fusogenic activity, downstream gene transcription in a temporal and spatial manner, and/or increased diversity of placental structures.
Topics: Animals; Endogenous Retroviruses; Evolution, Molecular; Female; Phylogeny; Placenta; Pregnancy; Retroelements; Trophoblasts
PubMed: 28110755
DOI: 10.1016/bs.pmbts.2016.12.004 -
Animal Reproduction Science Oct 2023Developmental programming, which proposes that "insults" or "stressors" during intrauterine or postnatal development can have not only immediate but also long-term... (Review)
Review
Developmental programming, which proposes that "insults" or "stressors" during intrauterine or postnatal development can have not only immediate but also long-term consequences for healthy and productivity, has emerged as a major biological principle, and based on studies in many animal species also seems to be a universal phenomenon. In eutherians, the placenta appears to be programmed during its development, which has consequences for fetal growth and development throughout pregnancy, and likewise has long-term consequences for postnatal development, leading to programming of organ function of the offspring even into adulthood. This review summarizes our current understanding of the placenta's role in developmental programming, the mechanisms involved, and the challenges remaining.
Topics: Pregnancy; Female; Animals; Placenta; Fetal Development
PubMed: 37696224
DOI: 10.1016/j.anireprosci.2023.107322 -
Magnetic Resonance in Medicine Dec 2022To develop and validate an MRI-based radiomics model for differentiating invasive placentas in patients with high risks.
PURPOSE
To develop and validate an MRI-based radiomics model for differentiating invasive placentas in patients with high risks.
METHODS
A total of 181 pregnant women suspected of placenta accreta spectrum (PAS) disorders and who underwent MRI for placenta evaluation were retrospectively enrolled. The data set was randomly divided into the training (n = 125; invasive = 63, noninvasive = 62) and test (n = 56; invasive = 28, noninvasive = 28) groups. Radiomics features were extracted from half-Fourier acquisition single-shot turbo spin echo (HASTE) and sagittal true fast imaging in steady-state precession (TRUFISP) sequences independently and mainly selected based on their correlations with invasive placentas to construct two radiomics signatures including HASTE-Radscore and TRUFISP-Radscore. Then, the predictive performance of radiomic signatures, clinical features, radiographic features, and their combination were evaluated. The model with the best predictive performance was validated with its discrimination ability, calibration, and clinical usefulness.
RESULTS
Five radiomics features from HASTE and three radiomics features from TRUFISP were retained, respectively, for predicting invasive placentas. The combination of radiomics signatures and clinical features including prior cesarean delivery, placenta previa, and radiographic feature, the placental thickness resulted in the best discrimination ability, with area under the curve of 0.898 (95% confidence interval [CI] 0.844-0.9522) and 0.858 (95% confidence interval 0.7514-0.9655) in the training and test cohort, respectively. The combined model showed a significantly better area under the curve performance and clinical usefulness than independent clinical or radiographic model according to DeLong test (p < .05), net reclassification improvement and integrated discrimination improvement analysis (positive improvement) and decision curve analysis (higher net benefit).
CONCLUSIONS
The T -weighted imaging MRI radiomics model could serve as a potential prenatal diagnosis tool for identifying invasive placentas in patients with high risks.
Topics: Female; Humans; Magnetic Resonance Imaging; Placenta; Placenta Accreta; Placenta Previa; Pregnancy; Retrospective Studies
PubMed: 36045635
DOI: 10.1002/mrm.29396 -
Journal of Reproductive Immunology Jun 2022Despite the central role of the placenta in supporting a pregnancy, relatively little is known about transcriptomic and immune-cell changes that occur across gestation....
Despite the central role of the placenta in supporting a pregnancy, relatively little is known about transcriptomic and immune-cell changes that occur across gestation. To generate a reference gene expression map of first (T1), second (T2) and third (T3) trimester human placenta, and assess differences in transcriptome in maternal versus fetal side tissues sections of full-term placenta, we performed RNA-Seq analysis on 64 biopsy samples from 18 placentas across all three gestations. We identified 1120 differentially expressed genes in placenta tissues from T1 and T3 samples using a generalized linear model within DESeq2. In total, 411 and 709 genes were positively associated with T1 and T3 placenta, respectively. Comparison of the top 200 differentially expressed genes in the T1 placenta with T3 showed that most of the top enriched biological processes were related to cell division and proliferation. T1 and T2 tissues shared expression of fibroblast-specific COL6A2, HGF, and SPP1 genes. In T3 samples, the expression of genes relating to vasculature development and regulation were highly enriched. Monocytes and NK cell population increased in T3 compared to T1 and T2, whereas Hofbauer cell proportion expanded significantly in T2 and then decreased in T3 samples. There were no significant gene expression differences in the maternal vs. fetal side in T3 placentas. Gene expression patterns shift temporally across trimesters but not spatially across the placenta, at least at the resolution of the biopsy samples. The genes and gene set we identified here represent a valuable resource for studying pathology in pregnancy-related disorders.
Topics: Female; Humans; Placenta; Pregnancy; Transcriptome
PubMed: 35490534
DOI: 10.1016/j.jri.2022.103624