title: Establishment of the Human Uteroplacental Circulation: A Historical Perspective.
abstract: The uterine vasculature undergoes marked changes during pregnancy in order to provide the necessary increase in blood flow to support growth and nutrition of the uterus, placenta, and developing fetus. Pregnancy-associated uterine vascular transformations are orchestrated by a complex array of endocrine and cellular mechanisms to bring about structural modifications at the maternal-fetal interface, which collectively lead to development of the uteroplacental circulation. Understanding intrinsic uterine vascular remodeling in pregnancy is essential for understanding the physiologic and pathophysiologic regulation of maternal uterine blood flow. Aberrations of uterine vascular remodeling are potentially involved in the etiology of several pregnancy disorders, for example, preeclampsia, fetal growth restriction, and preterm labor; therefore, it is essential for subspecialist clinicians and investigators interested in reproductive physiology to fully understand the establishment of uteroplacental circulation. The foundational literature in this area is extensive; thus, a succinct review is likely to be a useful resource. Herein, we present and discuss a historical perspective on uterine vascular anatomy, maternal vascular growth associated with decidualization, trophoblast invasion, intervillous circulation, aberrations in uterine vascular modeling, and the clinical implications of improper development of the uteroplacental circulation.
authors.affiliation: 1 Department of Obstetrics and Gynecology, Divisions of Maternal Fetal Medicine and Reproductive Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
authors.forename: Kenna
authors.initials: K
authors.lastname: Degner
authors.affiliation: 1 Department of Obstetrics and Gynecology, Divisions of Maternal Fetal Medicine and Reproductive Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.|2 Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.|3 Department of Animal Sciences, University of Wisconsin, Madison, WI, USA.|4 Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.|Current affiliation.
authors.forename: Ronald R
authors.initials: RR
authors.lastname: Magness
authors.affiliation: 1 Department of Obstetrics and Gynecology, Divisions of Maternal Fetal Medicine and Reproductive Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
authors.forename: Dinesh M
authors.initials: DM
authors.lastname: Shah
mesh_terms: D010064:Embryo Implantation; D005260:Female; D006801:Humans; D010920:Placenta / Q000098:blood supply* / Q000502:physiology; D021041:Placental Circulation; D011247:Pregnancy; D014327:Trophoblasts / Q000502:physiology; D014599:Uterus / Q000098:blood supply*; D066253:Vascular Remodeling
keywords: placenta; preeclampsia; pregnancy complications