Uteroplacental Circulation in Normal Pregnancy and Preeclampsia: Functional Adaptation and Maladaptation

• Published in: International journal of molecular sciences Vol. 22; no. 16; p. 8622
• Main Authors: Hu, Xiangqun, Zhang, Lubo
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 11.08.2021; MDPI
• Subjects: Adaptation; Adaptation, Physiological - physiology; Altitude; Angiogenesis; Animals; Arteries; Autoantibodies; Blood circulation; Blood flow; Blood pressure; Cytokines; Endothelium; Female; Fetuses; Hemodynamics; Hemodynamics - physiology; Humans; Hypoxia; Inflammation; Metabolism; Muscles; Nutrients; Placenta; Placenta - blood supply; Placental Circulation - physiology; Pre-eclampsia; Pre-Eclampsia - physiopathology; Preeclampsia; Pregnancy; Pregnancy - physiology; Pregnancy complications; Regulation; Review; Shear stress; Sheep; Smooth muscle; uteroplacental circulation; Uterus; Uterus - blood supply; Vascular Remodeling - physiology; vascular smooth muscle; Vasoactive agents; Veins & arteries; endothelium; adaptation; vascular smooth muscle; preeclampsia; pregnancy; uteroplacental circulation
• ISSN: 1422-0067; 1661-6596; 1422-0067
• DOI: 10.3390/ijms22168622

Uteroplacental blood flow increases as pregnancy advances. Adequate supply of nutrients and oxygen carried by uteroplacental blood flow is essential for the well-being of the mother and growth/development of the fetus. The uteroplacental hemodynamic change is accomplished primarily through uterine vascular adaptation, involving hormonal regulation of myogenic tone, vasoreactivity, release of vasoactive factors and others, in addition to the remodeling of spiral arteries. In preeclampsia, hormonal and angiogenic imbalance, proinflammatory cytokines and autoantibodies cause dysfunction of both endothelium and vascular smooth muscle cells of the uteroplacental vasculature. Consequently, the vascular dysfunction leads to increased vascular resistance and reduced blood flow in the uteroplacental circulation. In this article, the (mal)adaptation of uteroplacental vascular function in normal pregnancy and preeclampsia and underlying mechanisms are reviewed.