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Vascular changes in the cycling and early pregnant uterus
Noura Massri, Rachel Loia, Jennifer L. Sones, Ripla Arora, Nataki C. Douglas
Noura Massri, Rachel Loia, Jennifer L. Sones, Ripla Arora, Nataki C. Douglas
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Review

Vascular changes in the cycling and early pregnant uterus

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Abstract

Uterine vascular remodeling is intrinsic to the cycling and early pregnant endometrium. Maternal regulatory factors such as ovarian hormones, VEGF, angiopoietins, Notch, and uterine natural killer cells significantly mediate these vascular changes. In the absence of pregnancy, changes in uterine vessel morphology and function correlate with different stages of the human menstrual cycle. During early pregnancy, vascular remodeling in rodents and humans results in decreased uterine vascular resistance and increased vascular permeability necessary for pregnancy success. Aberrations in these adaptive vascular processes contribute to increased risk of infertility, abnormal fetal growth, and/or preeclampsia. This Review comprehensively summarizes uterine vascular remodeling in the human menstrual cycle, and in the peri- and post-implantation stages in rodent species (mice and rats).

Authors

Noura Massri, Rachel Loia, Jennifer L. Sones, Ripla Arora, Nataki C. Douglas

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Figure 2

Vascular remodeling from pre-implantation through decidualization.

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Vascular remodeling from pre-implantation through decidualization.
(A an...
(A and B) Longitudinal cross sections of the GD3.5 (A) and the GD4.5 (B) mouse uterus illustrating arteries (red), veins (blue), and the uterine lumen (outlined in gray). The utero-ovarian artery (UA) and vein (UV) give rise to the segmental arteries and veins, respectively (SA and SV). The segmental arteries divide into circumferential arterioles (CA) that then branch to form the spiral arterioles (SpA). Subepithelial capillary plexus (SCP) arise from the spiral arterioles and supply blood to the endometrium. Following embryo attachment at GD4.5 (B), the vessels remodel and dilate in proximity to the implantation region. (C and D) Transverse cross sections at GD5.5 (C) and GD7.5 (D). At GD5.5 (C) the newly formed decidual capillaries are readily apparent. By GD7.5 (D), the vasculature surrounding the implantation chamber can be divided into different regions — the central region surrounding the embryo (CTR), the mesometrial region (MR), and the anti–mesometrial region (AMR) — each with a unique composition of vessels. The MR is composed of spiral arterioles and capillaries. The spiral arterioles contain endothelial cells and mural cells (pericytes and VSMCs). The decidual capillaries in the AMR are smaller vessels composed of endothelial cells associated with pericytes, while the decidual capillaries in the CTR contain very few pericytes. AM, anti-mesometrial pole; Cx, cervix; E, embryo; M, mesometrial pole; Myo, myometrium; O, ovary; UF, uterine fold.

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ISSN 2379-3708

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