Oxygen as regulator of villous development

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There is an increasing recognition of the role oxidative stress inside the placenta plays in the pathophysiology of pregnancy disorders ranging from miscarriage to pre-eclampsia [1,13,15-17,30-32]. During the first trimester, villous trophoblast is well adapted to low oxygen; and it appears that trophoblast is more susceptible to raised oxygen rather than low oxygen [23,30,32]. Hence, during the first trimester if the upper side of the placenta is oxygenated by the onset of maternal blood flow, villi display increased evidence of oxidative stress, become avascular and finally regress. These physiological changes atthe abe-mbryonic pole result in the formation of the chorion laeve (Fig. 3.3).

If such early onset of maternal blood flow and consequently early onset of oxygenation occurs inside the whole placenta damage to the placenta itself will result. The most severe cases are missed miscarriages, while less severe cases may continue but may lead to pathologies such as pre-eclampsia and intrauterine growth restriction (IUGR) [13,17]. Itbecomes more and more clear thatin preeclampsia increased oxidative stress is evident; and recent data point to hyperoxic changes or to the occurrence of fluctuating oxygen concentrations [23,30].

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100 Pregnancy Tips

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